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关于新冠疫情期间当前抗病毒治疗的系统评价。

Systematic review on current antiviral therapy in COVID-19 pandemic.

作者信息

Perveen R A, Nasir M, Talha K A, Selina F, Islam M A

机构信息

Holy Family Red Crescent Medical College, Department of Pharmacology and Therapeutics, Bangladesh.

Sylhet Women's Medical College, Department of Neurosurgery, Bangladesh.

出版信息

Med J Malaysia. 2020 Nov;75(6):710-716.

Abstract

INTRODUCTION

Currently, there are several attempts to find an effective antiviral drugs against the COVID-19. Although majority of the COVID-19 patients have mild to moderate clinical events, up to 5-10% may have severe, life threatening events that urgently require effective drugs. The purpose of this systematic review is to evaluate the effectiveness of antiviral therapies in the treatment of COVID-19.

METHODS

An extensive search was performed in PubMed, EMBASE, Cochrane Library for randomised controlled trials (RCTs), prospective case series studies that evaluated therapies COVID-19. The outcomes searched for were mortality, recovery rate, length of hospital stay and clinical improvement from January to May 15, 2020. Independent reviewers searched, identified, screened, and related studies were included.

RESULTS

Total of five RCTs on 439 patients and seventeen case series involving 1656 patients were found in the specified review period that reported the use of Lopinavir, Ritonavir, Remdesivir. Oseltamivir, Ribavirin in patients with COVID-19; but none of which showed efficacy of antiviral therapy. Such current findings impede researchers from recommending an appropriate and effective antiviral therapy against COVID-19, making it a serious concern for the global community.

DISCUSSION

In the present pandemic and any future epidemics, all the related authorities should pursue many more RCTs, cohort and case series for a prospective outcome in the management and treatment guidelines.

摘要

引言

目前,人们正在进行多项尝试,以寻找针对新型冠状病毒肺炎(COVID-19)的有效抗病毒药物。尽管大多数COVID-19患者的临床症状为轻至中度,但仍有5%-10%的患者可能出现严重的、危及生命的症状,迫切需要有效的药物治疗。本系统评价的目的是评估抗病毒疗法在治疗COVID-19中的有效性。

方法

在PubMed、EMBASE、Cochrane图书馆中进行广泛检索,以查找评估COVID-19治疗方法的随机对照试验(RCT)和前瞻性病例系列研究。检索的结果包括2020年1月至5月15日期间的死亡率、康复率、住院时间和临床改善情况。由独立评审员进行检索、识别、筛选,并纳入相关研究。

结果

在指定的评价期内,共发现了5项针对439例患者的RCT和17项涉及1656例患者的病例系列研究,这些研究报告了洛匹那韦、利托那韦、瑞德西韦、奥司他韦、利巴韦林在COVID-19患者中的使用情况;但均未显示出抗病毒治疗的疗效。目前的这些研究结果阻碍了研究人员推荐一种合适且有效的抗COVID-19抗病毒疗法,这成为全球社会严重关切的问题。

讨论

在当前的大流行以及未来的任何疫情中,所有相关当局都应开展更多的RCT、队列研究和病例系列研究,以便为管理和治疗指南提供前瞻性结果。

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