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COVID-19 药物的治疗效果和安全性:系统评价和荟萃分析。

The therapeutic effect and safety of the drugs for COVID-19: A systematic review and meta-analysis.

机构信息

Department of Respiratory and Critical Care Medicine.

West China Medical School/West China Hospital.

出版信息

Medicine (Baltimore). 2021 Apr 23;100(16):e25532. doi: 10.1097/MD.0000000000025532.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread almost all regions of the world and caused great loss to the whole body of mankind. Thus, numerous clinical trials were conducted to find specific medicine for COVID-19 recently. However, it remains unanswered whether they are beneficial.

OBJECTIVE

This study aimed to evaluate the efficiency and safety of the COVID-19 medicine.

METHODS

Studies were determined through searching PubMed, Embase, Cochrane Library, and Medline. The studies of COVID-19 medicine were involved with eligible end points containing mortality, discharge rate, rate of clinical improvement, and rate of serious adverse events.

RESULTS

A total of 33 studies involving 37,879 patients were included in our study, whose intervening measures contained three major types of COVID-19 medicine, ACEI/ARB, antiviral medicine, and chloroquine/hydroxychloroquine. Compared to control group, COVID-19 drugs have no distinct effect on mortality (RR, 0.93; 95% CI, 0.79-1.11, P = .43) and discharge rate (RR, 1.06; 95% CI, 0.98-1.14, P = .13). However, antiviral medicine presents the obvious advantage in clinical improvement (RR, 1.11; 95% CI, 1.01-1.23, P < .05). In addition, the serious adverse events rate (RR, 0.75; 95% CI, 0.63-0.88, P < .05) of COVID-19 medicine is lower than control group.

CONCLUSION

The results indicated antiviral medicine was potential specific medicine for COVID-19 treatment by improving clinical symptoms, but it failed to increase the discharge rate and reduce mortality. Chloroquine/hydroxychloroquine and ACEI/ARB had no significant effect on treatment of COVID-19, thus they were not recommended for routine medication. Moreover, more trials are needed to find effective drugs to lower the mortality of COVID-19 patients.

摘要

背景

2019 年冠状病毒病(COVID-19)已在世界几乎所有地区传播,给全人类造成了巨大损失。因此,最近进行了许多临床试验以寻找针对 COVID-19 的特效药。然而,它们是否有效仍不得而知。

目的

本研究旨在评估 COVID-19 药物的疗效和安全性。

方法

通过检索 PubMed、Embase、Cochrane Library 和 Medline 来确定研究。纳入的 COVID-19 药物研究包含有死亡率、出院率、临床改善率和严重不良事件发生率等合格终点的研究。

结果

共纳入 33 项研究,涉及 37879 例患者,干预措施包含三种主要类型的 COVID-19 药物,即血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂(ACEI/ARB)、抗病毒药物和氯喹/羟氯喹。与对照组相比,COVID-19 药物对死亡率(RR,0.93;95%CI,0.79-1.11,P=0.43)和出院率(RR,1.06;95%CI,0.98-1.14,P=0.13)无明显影响。然而,抗病毒药物在临床改善方面具有明显优势(RR,1.11;95%CI,1.01-1.23,P<.05)。此外,COVID-19 药物的严重不良事件发生率(RR,0.75;95%CI,0.63-0.88,P<.05)低于对照组。

结论

结果表明,抗病毒药物可能是 COVID-19 治疗的特效药物,可改善临床症状,但不能提高出院率和降低死亡率。氯喹/羟氯喹和 ACEI/ARB 对 COVID-19 的治疗无明显作用,因此不推荐常规使用。此外,还需要更多的试验来寻找有效的药物以降低 COVID-19 患者的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7ef/8078467/f416d2723edc/medi-100-e25532-g001.jpg

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