Sánchez-Rico Marina, Limosin Frédéric, Vernet Raphaël, Beeker Nathanaël, Neuraz Antoine, Blanco Carlos, Olfson Mark, Lemogne Cédric, Meneton Pierre, Daniel Christel, Paris Nicolas, Gramfort Alexandre, Lemaitre Guillaume, De La Muela Pedro, Salamanca Elisa, Bernaux Mélodie, Bellamine Ali, Burgun Anita, Hoertel Nicolas
Département de Psychiatrie, Hôpital Corentin-Celton, AP-HP.Centre-Université de Paris, 92130 Issy-les-Moulineaux, France.
Department of Psychobiology & Behavioural Sciences Methods, Faculty of Psychology, Campus de Somosaguas Universidad Complutense de Madrid, 28223 Pozuelo de Alarcon, Spain.
J Clin Med. 2021 Dec 15;10(24):5891. doi: 10.3390/jcm10245891.
(1) Background: Based on its antiviral activity, anti-inflammatory properties, and functional inhibition effects on the acid sphingomyelinase/ceramide system (FIASMA), we sought to examine the potential usefulness of the H1 antihistamine hydroxyzine in patients hospitalized for COVID-19. (2) Methods: In a multicenter observational study, we included 15,103 adults hospitalized for COVID-19, of which 164 (1.1%) received hydroxyzine within the first 48 h of hospitalization, administered orally at a median daily dose of 25.0 mg (SD = 29.5). We compared mortality rates between patients who received hydroxyzine at hospital admission and those who did not, using a multivariable logistic regression model adjusting for patients' characteristics, medical conditions, and use of other medications. (3) Results: This analysis showed a significant association between hydroxyzine use and reduced mortality (AOR, 0.51; 95%CI, 0.29-0.88, = 0.016). This association was similar in multiple sensitivity analyses. (4) Conclusions: In this retrospective observational multicenter study, the use of the FIASMA hydroxyzine was associated with reduced mortality in patients hospitalized for COVID-19. Double-blind placebo-controlled randomized clinical trials of hydroxyzine for COVID-19 are needed to confirm these results, as are studies to examine the potential usefulness of this medication for outpatients and as post-exposure prophylaxis for individuals at high risk for severe COVID-19.
(1) 背景：基于其抗病毒活性、抗炎特性以及对酸性鞘磷脂酶/神经酰胺系统的功能抑制作用（FIASMA），我们试图研究H1抗组胺药羟嗪在因新冠肺炎住院患者中的潜在效用。(2) 方法：在一项多中心观察性研究中，我们纳入了15103名因新冠肺炎住院的成年人，其中164人（1.1%）在住院的前48小时内接受了羟嗪治疗，口服给药，中位日剂量为25.0毫克（标准差 = 29.5）。我们使用多变量逻辑回归模型，对患者的特征、医疗状况和其他药物的使用情况进行调整，比较了入院时接受羟嗪治疗的患者和未接受治疗的患者的死亡率。(3) 结果：该分析表明，使用羟嗪与降低死亡率之间存在显著关联（调整后的比值比，0.51；95%置信区间，0.29 - 0.88，P = 0.016）。在多项敏感性分析中，这种关联相似。(4) 结论：在这项回顾性观察性多中心研究中，使用FIASMA羟嗪与因新冠肺炎住院患者的死亡率降低相关。需要进行羟嗪治疗新冠肺炎的双盲安慰剂对照随机临床试验来证实这些结果，还需要开展研究以检验这种药物对门诊患者的潜在效用以及作为严重新冠肺炎高危个体的暴露后预防措施的效果。
