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羟氯喹在 COVID-19 中无益:随机对照试验的系统评价和荟萃分析结果。

No benefit of hydroxychloroquine in COVID-19: Results of Systematic Review and Meta-Analysis of Randomized Controlled Trials".

机构信息

MMIMSR, MM Deemed to be University, Ambala, Haryana, India.

Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India.

出版信息

Diabetes Metab Syndr. 2020 Nov-Dec;14(6):1673-1680. doi: 10.1016/j.dsx.2020.08.033. Epub 2020 Sep 1.

Abstract

BACKGROUND AND AIMS

Coronavirus pandemic is currently a global public health emergency with no definitive treatment guidelines. We conducted a systematic review and meta-analysis of the literature evaluating the efficacy of hydroxychloroquine and its related formulations in COVID-19 patients.

METHODS

A systematic search of PubMed, Scopus, MedRxiv data and Cochrane Central Register of Clinical Trials for published articles that reported the outcomes of COVID-19 patients treated with hydroxychloroquine or its compounds was done. We identified 1071 published studies and 7 studies were included in the analysis.

RESULTS

The study population consisted of a total of 4984 patients, of which 1721 (34.5%) received hydroxychloroquine or its congeners (HCQ group) while 3091 (62.01%) received standard of care or had included antiviral medication (control group). The pooled estimate of successful treatment in the hydroxychloroquine group and the control group was 77.45% and 77.87% respectively, which indicated similar clinical outcomes in patients treated with hydroxychloroquine compared to the control group. The odds ratio of a favourable outcome with hydroxychloroquine was 1.11 (95 CI 0.72 to 1.69) (p = 0.20). The pooled risk difference of favourable outcome with hydroxychloroquine versus control group was 0.00 (95 CI -0.03 to 0.03) which was statistically not significant (p = 0.10).

CONCLUSIONS

The present evidence shows no benefit of hydroxychloroquine in patients affected by mild to moderate COVID-19 disease. However, now several trials on HCQ are ongoing and hopefully more data will be available soon. Hence, the management of COVID-19 is set to change for better in the future.

摘要

背景和目的

冠状病毒大流行目前是全球公共卫生紧急事件,尚无明确的治疗指南。我们对评估羟氯喹及其相关制剂在 COVID-19 患者中的疗效的文献进行了系统评价和荟萃分析。

方法

对 PubMed、Scopus、MedRxiv 数据和 Cochrane 临床试验中心注册库中发表的报告 COVID-19 患者接受羟氯喹或其化合物治疗结果的文章进行了系统搜索。我们确定了 1071 篇已发表的研究,其中有 7 项研究纳入分析。

结果

研究人群共包括 4984 例患者,其中 1721 例(34.5%)接受羟氯喹或其类似物(HCQ 组)治疗,3091 例(62.01%)接受标准治疗或包括抗病毒药物治疗(对照组)。羟氯喹组和对照组的治疗成功率的汇总估计值分别为 77.45%和 77.87%,表明接受羟氯喹治疗的患者与对照组的临床结局相似。羟氯喹治疗的有利结局的优势比为 1.11(95%CI 0.72 至 1.69)(p=0.20)。羟氯喹与对照组相比,有利结局的汇总风险差异为 0.00(95%CI -0.03 至 0.03),无统计学意义(p=0.10)。

结论

目前的证据表明,羟氯喹对轻度至中度 COVID-19 疾病患者没有益处。然而,目前正在进行几项关于 HCQ 的试验,希望很快会有更多的数据。因此,未来 COVID-19 的治疗将得到更好的改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5c6/7462641/796a82f39934/gr1_lrg.jpg

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