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抗抑郁药治疗 COVID-19:系统评价。

Antidepressants for COVID-19: A systematic review.

机构信息

The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.

Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macau SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macau SAR, China.

出版信息

J Affect Disord. 2022 Jun 15;307:108-114. doi: 10.1016/j.jad.2022.03.059. Epub 2022 Mar 23.

Abstract

OBJECTIVE

To systematically examine the efficacy and safety of antidepressants for the treatment of coronavirus disease 2019 (COVID-19).

METHODS

A systematic search was performed independently by two researchers based on Chinese Journal Net, WanFang, PsycINFO, Cochrane Library, PubMed, and EMBASE.

RESULTS

Seven studies (n = 92,947) including three retrospective studies (n = 91,083), two randomized clinical trials (RCTs, n = 1649), two prospective cohort study (n = 215) involving (n = 92,947) patients with COVID-19 were examined. For RCTs, fluvoxamine outperformed placebo in reducing clinical deterioration and hospitalisation for COVID-19 patients. For retrospective studies, antidepressants (2 studies) and fluoxetine (1 study) possibly reduced the risk of mortality in patients with COVID-19. Results from two remaining studies supported the superiority of fluvoxamine in reducing risk of mortality in COVID-19 patients. The two RCTs that examined the safety of fluvoxamine for COVID-19 patients found inconsistent results but no significant group differences in the dropout rate.

CONCLUSION

This systematic review found emerging evidence for fluvoxamine in reducing the risk of mortality and hospitalisation in COVID-19 patients, but inconsistent evidence for the safety of fluvoxamine in COVID-19 patients. More studies are needed to determine the efficacy and safety of antidepressants for the treatment of COVID-19.

摘要

目的

系统评估抗抑郁药治疗 2019 冠状病毒病(COVID-19)的疗效和安全性。

方法

两位研究者独立基于中国知网、万方、PsycINFO、 Cochrane Library、PubMed 和 EMBASE 进行系统检索。

结果

共纳入 7 项研究(n=92947),包括 3 项回顾性研究(n=91083)、2 项随机对照试验(RCT,n=1649)和 2 项前瞻性队列研究(n=215),共纳入 92947 例 COVID-19 患者。对于 RCT 研究,氟伏沙明在降低 COVID-19 患者临床恶化和住院风险方面优于安慰剂。对于回顾性研究,抗抑郁药(2 项研究)和氟西汀(1 项研究)可能降低 COVID-19 患者的死亡率。另外 2 项研究的结果支持氟伏沙明降低 COVID-19 患者死亡率的优势。两项评估氟伏沙明治疗 COVID-19 患者安全性的 RCT 研究得出了不一致的结果,但两组间的脱落率无显著差异。

结论

本系统评价发现氟伏沙明在降低 COVID-19 患者的死亡率和住院风险方面有新的证据,但氟伏沙明治疗 COVID-19 患者的安全性证据不一致。需要更多的研究来确定抗抑郁药治疗 COVID-19 的疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b8b/8941844/4e16dc8e019c/gr1_lrg.jpg

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