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H受体阻滞剂法莫替丁对新型冠状病毒肺炎患者临床康复的作用:一项随机对照试验。

Role of H receptor blocker famotidine over the clinical recovery of COVID-19 patients: A randomized controlled trial.

作者信息

Mohiuddin Chowdhury Abu Taiub Mohammed, Kamal Aktar, Abbas Md Kafil Uddin, Karim Md Rezaul, Ali Md Ahsan, Talukder Shubhashis, Hamidullah Mehedi H M, Hassan Hamid, Shahin Abul Hossain, Li Yarui, He Shuixiang

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.

Ministry of Health and Family Welfare (OSD-DGHS), Dhaka 1212, Bangladesh.

出版信息

World J Clin Cases. 2022 Aug 16;10(23):8170-8185. doi: 10.12998/wjcc.v10.i23.8170.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a global pandemic putting the population at a high risk of infection-related health hazards, mortality and a potential failure of proper medical therapies. Therefore, it is necessary to evaluate the potential use of the existing drugs that could be used as options for the medical management of COVID-19 patients.

AIM

To evaluate the role of the H receptor blocker "famotidine" in COVID-19 illness.

METHODS

This study was done on seriously ill COVID-19 patients admitted to the intensive care unit (ICU) from different institutes in Bangladesh. Patients were divided into famotidine treatment group "A" (famotidine 40 mg to 60 mg oral formulation every 8 h with other treatment as given), and control group "B" (treatment as given). National early warning score (NEWS)-2, and sequential organ failure assessment day-1 score was calculated to evaluate the outcome. Outcomes were evaluated by the time required for clinical improvement, characterized as duration required from enrollment to the achievement of NEWS-2 of ≤ 2 maintained for 24 h; time to symptomatic recovery, defined as the duration in days (from randomization) required for the recovery of the COVID-19 symptoms; mortality rate; duration of ICU and hospital stay; total period of hospitalization; the rate of supplementary oxygen requirement; the computed tomography (CT) chest recovery (%), the time required for the viral clearance and "NEWS-2" on discharge.

RESULTS

A total of 208 patients were enrolled in this study with 104 patients in each group. The famotidine treatment group had comparatively better recovery of 75% and a low mortality of 25% than the control with a recovery of 70% and a mortality of 30%. Duration of clinical improvement (group A 9.53 d, group B 14.21 d); hospitalization period among the recovered patients (group A 13.04 d, group B 16.31 d), pulmonary improvement in chest CT (group A 21.7%, group B 13.2%), and the time for viral clearance (group A 20.7 d, group B 23.8 d) were found to be statistically significant ≤ 0.05. However, the Kaplan Meier survival test was not significant among the two study groups, = 0.989.

CONCLUSION

According to our study, treatment with famotidine achieved a better clinical outcome compared to the control group in severe COVID-19 illness, although no significant survival benefit was found.

摘要

背景

2019冠状病毒病(COVID-19)是一场全球大流行疾病,使人们面临与感染相关的健康危害、死亡以及适当医疗治疗可能失败的高风险。因此,有必要评估现有药物作为COVID-19患者医疗管理选择的潜在用途。

目的

评估H受体阻滞剂“法莫替丁”在COVID-19疾病中的作用。

方法

本研究针对从孟加拉国不同机构收治入重症监护病房(ICU)的重症COVID-19患者进行。患者分为法莫替丁治疗组“A”(每8小时口服40毫克至60毫克法莫替丁制剂,并给予其他治疗)和对照组“B”(给予常规治疗)。计算国家早期预警评分(NEWS)-2和序贯器官衰竭评估第1天评分以评估结果。通过临床改善所需时间来评估结果,临床改善定义为从入组到达到NEWS-2≤2并维持24小时所需的持续时间;症状恢复时间,定义为COVID-19症状恢复所需的天数(从随机分组开始);死亡率;ICU和住院时间;总住院时间;补充氧气需求率;胸部计算机断层扫描(CT)恢复率(%);病毒清除所需时间以及出院时的“NEWS-2”。

结果

本研究共纳入208例患者,每组104例。法莫替丁治疗组的恢复情况相对较好,恢复率为75%,死亡率为25%,而对照组的恢复率为70%,死亡率为30%。临床改善持续时间(A组9.53天,B组14.21天);康复患者的住院时间(A组13.04天,B组16.31天),胸部CT肺部改善情况(A组21.7%,B组13.2%)以及病毒清除时间(A组20.7天,B组23.8天)在统计学上均有显著差异(P≤0.05)。然而,两组之间的Kaplan Meier生存检验无显著差异(P = 0.989)。

结论

根据我们的研究,在重症COVID-19疾病中,与对照组相比,法莫替丁治疗取得了更好的临床结果,尽管未发现显著的生存获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e4b/9403664/2e6764816148/WJCC-10-8170-g001.jpg

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