Guillermo Rojas Mijangos SN, Ciudad Universitaria, Miahuatlan de Porfirio Diaz, Oaxaca, 70800, Mexico.
Postgraduate Department, University of Sierra Sur, Miahuatlan de Porfirio Diaz, Oaxaca, 70800, Mexico.
Ther Adv Respir Dis. 2021 Jan-Dec;15:17534666211007214. doi: 10.1177/17534666211007214.
The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection. We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization, virological clearance, and severe adverse events. A total of 48 studies were retrieved from the databases. Eleven articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir. We can conclude that dexamethasone would have a better result in hospitalized patients, especially in low-resources settings. The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries, since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources.
目的是评估在 COVID-19 感染住院患者中使用的药物的临床疗效。我们对评估瑞德西韦、氯喹、羟氯喹、洛匹那韦、利托那韦、地塞米松和恢复期血浆治疗住院 SARS-CoV-2 感染患者的随机临床试验进行了系统评价。结局指标包括死亡率、临床改善、通气时间、氧疗支持时间、住院时间、病毒学清除率和严重不良事件。从数据库中检索到 48 项研究。最终有 11 篇文章纳入数据提取和结果定性综合分析。荟萃分析提示，与标准治疗相比，地塞米松治疗可降低 28 天死亡率风险；瑞德西韦治疗可改善 14 天和 28 天的临床症状。我们可以得出结论，地塞米松可能对住院患者更有效，特别是在资源匮乏的环境中。分析对住院患者提出的主要治疗方法对于降低低收入国家的死亡率至关重要，因为 COVID-19 大流行在全球范围内造成了经济影响，使资源匮乏的国家失业和经济衰退。
