Kazempour Muhanna, Izadi Hossein, Chouhdari Arezoo, Rezaeifard Morteza
Department of Rheumatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, Shohada Gomnam Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Pharm Res. 2021 Summer;20(3):532-540. doi: 10.22037/ijpr.2021.114567.14917.
Metronidazole (MTZ) can decrease the levels of several cytokines. This research aimed at the investigation of the anti-inflammatory impact of MTZ in COVID-19. A randomized, single-blind clinical trial for comparing the anti-inflammatory effect of MTZ in two eligible groups of adult patients with lower respiratory tract involvement due to Covid-19 treated with a standard national method with or without MTZ was performed. Inflammatory markers were measured as the primary outcome in two groups. Oxygen saturation, length of hospital stays, and mortality of patients were evaluated as secondary outcomes. Among 44 patients with lower respiratory tract due to Covid-19, 20(45.5%) were randomly allocated in group A with the current standard treatment plus the MTZ tablet for 7 days orally and 24 (54.5%) in group B with the current standard treatment. The mean of in group A was statistically significantly lower than that of group B on the seventh day (A: 38.25 ± 18.75 B: 47.67 ± 26.41, = 0.02). Moreover, the mean of diminished significantly in both A ( = 0.01) and B ( = 0.01) groups on the seventh day compared to the first day. The decrease of was not significant in any of the groups A ( = 0.3) and B ( = 0.4) from the 7 day to the first day. No significant difference was not found between group A and group B groups on the level ( = 0.1). Findings of this study showed the anti-inflammatory impact of MTZ in the patient with lower respiratory inflammation due to COVID-19.
甲硝唑（MTZ）可降低多种细胞因子水平。本研究旨在探讨MTZ对新型冠状病毒肺炎（COVID-19）的抗炎作用。进行了一项随机、单盲临床试验，比较MTZ对两组符合条件的因COVID-19导致下呼吸道受累的成年患者的抗炎效果，一组采用标准国家治疗方法加MTZ片剂口服7天，另一组仅采用标准国家治疗方法。炎症标志物作为两组的主要观察指标。患者的血氧饱和度、住院时间和死亡率作为次要观察指标进行评估。在44例因COVID-19导致下呼吸道受累的患者中，20例（45.5%）被随机分配到A组，接受当前标准治疗加MTZ片剂口服7天，24例（54.5%）被分配到B组，仅接受当前标准治疗。在第7天，A组的[具体指标未给出]平均值在统计学上显著低于B组（A组：38.25±18.75，B组：47.67±26.41，P = 0.02）。此外，与第1天相比，第7天A组（P = 0.01）和B组（P = 0.01）的[具体指标未给出]平均值均显著降低。从第7天到第1天，A组（P = 0.3）和B组（P = 0.4）的[具体指标未给出]降低均无显著性差异。A组和B组在[具体指标未给出]水平上未发现显著差异（P = 0.1）。本研究结果表明MTZ对因COVID-19导致下呼吸道炎症的患者具有抗炎作用。
