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干扰素-β在中重度 COVID-19 住院病例中的疗效:系统评价和荟萃分析。

Efficacy of Interferon-β in Moderate-to-Severe Hospitalised Cases of COVID-19: A Systematic Review and Meta-analysis.

机构信息

All India Institute of Medical Sciences, Deoghar, India.

出版信息

Clin Drug Investig. 2021 Dec;41(12):1037-1046. doi: 10.1007/s40261-021-01092-9. Epub 2021 Oct 23.

Abstract

BACKGROUND AND OBJECTIVE

Interferon-β, as with several other anti-viral agents, has been investigated as a treatment option for COVID-19 as a repurposed drug. The present study is a systematic review and meta-analysis of interferon-β to determine its efficacy among moderate-to-severe COVID-19 patients.

METHODS

A systematic literature search was done using relevant terms for 'COVID-19' and 'interferon-β'. Randomised controlled trials (RCT) evaluating the efficacy of interferon-β in COVID-19 were included. Data were extracted for outcome measures, namely mortality, time to clinical improvement and length of hospital stay. Random effects meta-analysis was performed using RevMan V.5.4.1 to calculate overall effect estimate as odds ratio/hazard ratio for categorical variables and mean difference for continuous variable.

RESULT

Eight RCTs were eligible for qualitative synthesis and seven for meta-analysis. The overall effect estimate (odds ratio [OR] 0.59; 95 % CI 0.91, 1.12) and (mean difference [MD] - 1.41; 95 % CI - 2.84, 0.02) indicated no statistically significant difference between effect of IFN-β and that of control on mortality and length of hospital stay, respectively. However, the overall effect estimate (hazard ratio [HR] 1.95; 95 % CI 1.36, 2.79) denoted a favourable effect of INF-β on reducing the time to clinical improvement in moderate-to-severe COVID-19 patients.

CONCLUSION

Addition of interferon-β to standard of care resulted in significant reduction in time to clinical improvement but no significant benefit in terms of reduction in mortality and length of hospital stay in moderate-to-severe cases of COVID-19.

摘要

背景与目的

干扰素-β与其他几种抗病毒药物一样,已被作为一种重新利用的药物,被研究用于治疗 COVID-19。本研究是对干扰素-β的系统评价和荟萃分析,以确定其在中重度 COVID-19 患者中的疗效。

方法

使用“COVID-19”和“干扰素-β”的相关术语进行系统文献检索。纳入评估干扰素-β在 COVID-19 中的疗效的随机对照试验(RCT)。提取结局指标的数据,即死亡率、临床改善时间和住院时间。使用 RevMan V.5.4.1 进行随机效应荟萃分析,计算总体效应估计值,即分类变量的比值比/风险比和连续变量的均数差。

结果

有 8 项 RCT 适合定性综合分析,7 项适合荟萃分析。总体效应估计值(比值比 [OR] 0.59;95%CI 0.91, 1.12)和(均数差 [MD] -1.41;95%CI -2.84, 0.02)表明,干扰素-β与对照组在死亡率和住院时间上的疗效无统计学差异。然而,总体效应估计值(风险比 [HR] 1.95;95%CI 1.36, 2.79)表示干扰素-β对缩短中重度 COVID-19 患者临床改善时间有有利影响。

结论

在标准治疗基础上加用干扰素-β可显著缩短临床改善时间,但在中重度 COVID-19 病例中,死亡率和住院时间无显著获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6d8/8540871/3634eef0c253/40261_2021_1092_Fig1_HTML.jpg

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