用于治疗住院 COVID-19 患者的皮质类固醇治疗方案的疗效和安全性：一项荟萃分析。
Efficacy and safety of corticosteroid regimens for the treatment of hospitalized COVID-19 patients: a meta-analysis.
作者信息
Zhou Fangwen, Deng Jiawen, Heybati Kiyan, Zuo Qi Kang, Ali Saif, Hou Wenteng, Wong Chi Yi, Ramaraju Harikrishnaa Ba, Chang Oswin, Dhivagaran Thanansayan, Silver Zachary
机构信息
Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
Mayo Clinic Alix School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
出版信息
Future Virol. 2022 Jul;17(7):463-489. doi: 10.2217/fvl-2021-0244. Epub 2022 Jun 3.
AIM
To evaluate the efficacy and safety of corticosteroids for treating hospitalized COVID-19 patients.
MATERIALS & METHODS: Efficacy outcomes included time to negative SARS-CoV-2 tests, length of stay, duration and incidence of intensive unit care stay, incidence of mortality and duration and incidence of mechanical ventilation. Safety outcomes included the incidence of adverse events and severe adverse events, incidence of hyperglycemia and incidence of nosocomial infections.
RESULTS
Ninety-five randomized controlled trials (RCTs) and observational studies (n = 42,205) were included. Corticosteroids were associated with increased length of stay (based on RCT only), increased time to negative tests, decreased length of mechanical ventilation and increased odds of hyperglycemia.
CONCLUSION
Corticosteroids should be considered in patients requiring mechanical ventilation, and glycemic monitoring may be needed when administering corticosteroids.
目的
评估皮质类固醇治疗住院的2019冠状病毒病（COVID-19）患者的疗效和安全性。
材料与方法
疗效指标包括新型冠状病毒2（SARS-CoV-2）检测转阴时间、住院时间、重症监护病房（ICU）住院时长及发生率、死亡率、机械通气时长及发生率。安全性指标包括不良事件和严重不良事件的发生率、高血糖症的发生率及医院感染的发生率。
结果
纳入了95项随机对照试验（RCT）和观察性研究（n = 42,205）。皮质类固醇与住院时间延长（仅基于RCT）、检测转阴时间延长、机械通气时间缩短以及高血糖几率增加有关。
结论
对于需要机械通气的患者应考虑使用皮质类固醇，使用皮质类固醇时可能需要进行血糖监测。
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