Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
Expert Rev Anti Infect Ther. 2022 Apr;20(4):585-609. doi: 10.1080/14787210.2022.1997587. Epub 2021 Dec 29.
Up to now, numerous randomized controlled trials (RCTs) have examined various drugs as possible treatments for Coronavirus Disease 2019 (COVID-19), but the results were diverse and occasionally even inconsistent with each other. To this point,we performed a systematic review and meta-analysis to assess the comparative effectiveness of pharmacological agents in published RCTs.
A literature search was performed using PubMed, SCOPUS, EMBASE, and Web of Science databases. RCTs evaluating mortality and the average length of hospital stay to standard of care (SOC)/placebo/control were included. RCTs mainly were classified into five categories of drugs, including anti-inflammatory, antiviral, antiparasitic, antibody and antibiotics. Meta-analysis was done on 5 drugs classes and sub-group meta-analysis was done on single drugs and moderate or severe stage of disease.
Mortality and the average length of hospital stay of COVID-19 patients were significantly reduced with anti-inflammatory drugs (odds ratio [OR]: 0.77, 95% confidence interval [CI]: 0.69 to 0.85, P<0.00001, and mean difference [MD]: -1.41, CI:-1.75 to -1.07, P<0.00001, respectively) compared to SOC/control/placebo. Furthermore, antiparasitic was associated with reduced length of hospital stay (MD: -0.65, CI: -1.26 to -0.03, P<0.05) in comparison to SOC/placebo/control. However, no effectiveness was found in other pharmacological interventions.
迄今为止，已有大量随机对照试验（RCT）研究了多种药物对 2019 年冠状病毒病（COVID-19）的潜在治疗作用，但结果各异，甚至相互矛盾。为此，我们进行了系统评价和荟萃分析，以评估已发表 RCT 中药物治疗的相对疗效。
使用 PubMed、SCOPUS、EMBASE 和 Web of Science 数据库进行文献检索。纳入评估死亡率和平均住院时间与标准治疗（SOC）/安慰剂/对照的 RCT。RCT 主要分为五类药物，包括抗炎药、抗病毒药、抗寄生虫药、抗体和抗生素。对 5 类药物进行了荟萃分析，并对单药和中重度疾病进行了亚组荟萃分析。
与 SOC/安慰剂/对照相比，抗炎药可显著降低 COVID-19 患者的死亡率和平均住院时间（比值比[OR]：0.77，95%置信区间[CI]：0.69 至 0.85，P<0.00001；均数差[MD]：-1.41，CI：-1.75 至 -1.07，P<0.00001）。此外，与 SOC/安慰剂/对照相比，抗寄生虫药可缩短住院时间（MD：-0.65，CI：-1.26 至 -0.03，P<0.05）。然而，其他药物干预措施均未见疗效。
