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住院 COVID-19 患者应用法匹拉韦治疗的获益:一项回顾性观察性病例对照研究。

Benefits of treatment with favipiravir in hospitalized patients for COVID-19: a retrospective observational case-control study.

机构信息

Department of Internal Medicine, Eskisehir City Hospital, 71 Evler Neighborhood, Çavdarlar Street, 26080, Odunpazarı, Eskişehir, Turkey.

Division of Immunology, Department of Internal Medicine, Eskisehir City Hospital, 71 Evler Neighborhood, Çavdarlar Street, 26080, Odunpazarı, Eskişehir, Turkey.

出版信息

Virol J. 2021 May 25;18(1):102. doi: 10.1186/s12985-021-01577-1.

Abstract

BACKGROUND

Although more than a year past since COVID-19 was defined, there is no specific treatment yet. Since COVID-19 management differs over time, it is hard to determine which therapy is more efficacious. In this study, we aimed to evaluate the efficacy of the regimen with Favipiravir (FPV) and determine if the timing of FPV addition offers any improvement.

METHODS

A retrospective observational case-controlled cohort study was performed between March and September 2020, including adults with COVID-19 in a single-center in Turkey. We categorized patients into age-sex matched three groups, group 1 (n = 48) and group 2 (n = 48) included patients treated with the combination of FPV plus Hydroxychloroquine (HQ) early and late, respectively. Group 3 (n = 48) consisted of patients on HQ monotherapy. In Group 2, if the respiratory or clinic condition had not improved sufficiently, FPV was added on or after day 3.

RESULTS

We found that starting FPV early had an impact on PCR negativity and the progression of the disease. 'No progression' was defined as the absence of a new finding in the control radiological examination and the absence of accompanying clinical deterioration. Also, the decrease in C-reactive protein (CRP) was greater in Group 1 than Group 3 (p < 0.001). However, we found that early initiation of FPV treatment did not have a positive effect on the estimated survival time.

CONCLUSIONS

According to this retrospective study results, we believe that for better clinical outcomes, FPV treatment should be started promptly to enhance antiviral effects and improve clinical outcomes.

摘要

背景

尽管 COVID-19 被定义已经超过一年,但目前仍没有特异性治疗方法。由于 COVID-19 的管理随时间而变化,因此难以确定哪种疗法更有效。在本研究中,我们旨在评估使用法匹拉韦(FPV)的治疗方案的疗效,并确定 FPV 加用的时机是否有任何改善。

方法

这是一项回顾性观察性病例对照队列研究,于 2020 年 3 月至 9 月在土耳其的一家单中心进行,纳入了 COVID-19 成年患者。我们将患者分为年龄性别匹配的三组,组 1(n=48)和组 2(n=48)分别为早期和晚期接受 FPV 联合羟氯喹(HQ)治疗的患者。组 3(n=48)由 HQ 单药治疗的患者组成。在组 2 中,如果呼吸或临床状况没有得到充分改善,则在第 3 天或之后加用法匹拉韦。

结果

我们发现早期开始使用 FPV 对 PCR 阴性和疾病进展有影响。“无进展”定义为在对照影像学检查中无新发现且无伴随临床恶化。此外,与组 3 相比,组 1 的 C 反应蛋白(CRP)下降更大(p<0.001)。然而,我们发现早期开始 FPV 治疗对估计的生存时间没有积极影响。

结论

根据这项回顾性研究结果,我们认为为了获得更好的临床结果,应尽快开始 FPV 治疗,以增强抗病毒作用并改善临床结果。

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