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皮下注射β-干扰素治疗新型冠状病毒肺炎的疗效:一项荟萃分析与系统评价

Efficacy of subcutaneous interferon-beta in COVID-19: a meta-analysis and systematic review.

作者信息

Asif Abuzar A, Hussain Habiba, Senthil Kumaran Sriviji, Syed Salman B, Vanka Varun, Tharoor Manisha, Rangwala Umme Salma, Rathore Urvashi, Singhal Malay, Chatterjee Tulika

机构信息

Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA.

Department of Internal Medicine, OSF Saint Francis Medical Center, Peoria, IL, USA.

出版信息

J Community Hosp Intern Med Perspect. 2021 Nov 15;11(6):760-768. doi: 10.1080/20009666.2021.1984644. eCollection 2021.

Abstract

Type 1 interferons, especially interferon-beta, has been reported to be effective in COVID-19 patients in multiple randomized controlled trials. The aim of our meta-analysis and systematic review is to assess efficacy of subcutaneous IFN-beta in regards to mortality and discharge rate. Prospective, retrospective and randomized controlled trials were included. Primary outcomes measured were 28-day mortality and discharge rate. Secondary outcomes measured were mean hospital stay and post-intervention intubation rate. A thorough literature search was conducted in Medline, PubMed, Ovid journals, Google Scholar, and Cochrane Central Register of Controlled Trials & Database of Systematic Reviews from 1 April 2020 to 28 February 2021. Relative risk was calculated using both the Mantel-Haenszel method (fixed-effects model) and DerSimonian Laird method (random effects model). The heterogeneity among studies was tested using Cochran's Q test, based upon inverse variance weights. 7 studies were included in the meta-analysis and systematic review. The IFN-beta group did not improve the 28-day mortality (RR = 1.276; 95% CI: 1.106-1.472, p = 0.001) or the discharge rate (RR = 0.906; 95% CI = 0.85-0.95, p = < 0.001). The mean hospital stay was 11.95± 2.5 days in the interferon-beta group and 11.43 ± 3.74 days in the traditional treatment group. Likewise, interferon-beta did not add any advantage to post-intervention intubation rate (RR = 0.92; 95% CI = 0.7841-1.0816, p = 0.3154). Our findings revealed that use of subcutaneous interferon-beta is futile in COVID-19.

摘要

在多项随机对照试验中,据报道1型干扰素,尤其是β干扰素,对新冠肺炎患者有效。我们进行荟萃分析和系统评价的目的是评估皮下注射β干扰素在死亡率和出院率方面的疗效。纳入了前瞻性、回顾性和随机对照试验。测量的主要结局为28天死亡率和出院率。测量的次要结局为平均住院时间和干预后插管率。于2020年4月1日至2021年2月28日在Medline、PubMed、Ovid期刊、谷歌学术以及Cochrane对照试验中心注册库和系统评价数据库中进行了全面的文献检索。使用Mantel-Haenszel方法(固定效应模型)和DerSimonian Laird方法(随机效应模型)计算相对风险。基于逆方差权重,使用Cochran's Q检验对研究间的异质性进行检验。荟萃分析和系统评价纳入了7项研究。β干扰素组并未改善28天死亡率(RR = 1.276;95%CI:1.106 - 1.472,p = 0.001)或出院率(RR = 0.906;95%CI = 0.85 - 0.95,p = < 0.001)。β干扰素组的平均住院时间为11.95±2.5天,传统治疗组为11.43±3.74天。同样,β干扰素在干预后插管率方面也未带来任何优势(RR = 0.92;95%CI = 0.7841 - 1.0816,p = 0.3154)。我们的研究结果表明,皮下注射β干扰素对新冠肺炎无效。

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