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[与用于治疗新冠肺炎的药物潜在相关的中枢神经系统不良事件:范围综述 与用于治疗新冠肺炎的药物潜在相关的中枢神经系统不良事件:探索性综述]

[Central nervous system adverse events potentially associated with drugs used for COVID-19: scoping reviewEventos adversos en el sistema nervioso central potencialmente relacionados con los medicamentos para tratar la COVID-19: revisión exploratoria].

作者信息

de Mello Vinícius, Pereira Vinícius de Paula, Rodrigues João Paulo Vilela, Penteado Suelem Tavares da Silva, Pereira Leonardo Régis Leira, Varallo Fabiana Rossi

机构信息

Universidade de São Paulo (USP) Faculdade de Ciências Farmacêuticas de Ribeirão Preto Ribeirão Preto (SP) Brasil Universidade de São Paulo (USP), Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Ribeirão Preto (SP), Brasil.

出版信息

Rev Panam Salud Publica. 2022 Oct 25;46:e166. doi: 10.26633/RPSP.2022.166. eCollection 2022.

Abstract

OBJECTIVE

To identify central nervous system (CNS) adverse events potentially associated with prophylaxis or drug treatment for COVID-19, and to describe the characteristic of the individuals affected.

METHODS

A scoping review was performed using a search strategy to retrieve articles from PubMed, EMBASE, SciELO, Scopus, CINAHL and BVS databases. Studies reporting on individuals receiving prophylactic or curative drugs for COVID-19 with at least one CNS adverse event were included. Articles reporting on CNS adverse events associated with medication for other health conditions were excluded.

RESULTS

The search retrieved 1 547 articles, eight of which met the inclusion criteria. Seven studies had an observational design. A total of 3 035 individuals were assessed, of whom 1 701 were health care professionals and 1 978 were women. Curative treatment with hydroxychloroquine, chloroquine, lopinavir/ritonavir, and azithromycin was the most frequent (n = 5). The most common adverse events were headache, dizziness, mood disturbances, and drowsiness. Suicide was the most frequent severe event. Six adverse events were unexpected for hydroxychloroquine, chloroquine, and doxycycline.

CONCLUSION

Potential CNS adverse events were unspecific and in general potentially associated with the use of hydroxychloroquine (monotherapy or associated with antibiotics). The data confirm the unfavorable risk/benefit profile of these drugs for the prevention and management of signs and symptoms of SARS-CoV-2 infection.

摘要

目的

确定与2019冠状病毒病(COVID-19)预防或药物治疗潜在相关的中枢神经系统(CNS)不良事件,并描述受影响个体的特征。

方法

采用检索策略进行范围综述,以从PubMed、EMBASE、SciELO、Scopus、CINAHL和BVS数据库中检索文章。纳入报告接受COVID-19预防性或治疗性药物且至少发生1例CNS不良事件的个体的研究。排除报告与其他健康状况用药相关的CNS不良事件的文章。

结果

检索到1547篇文章,其中8篇符合纳入标准。7项研究采用观察性设计。共评估了3035名个体,其中1701名是医护人员,1978名是女性。使用羟氯喹、氯喹、洛匹那韦/利托那韦和阿奇霉素进行治疗是最常见的(n = 5)。最常见的不良事件是头痛、头晕、情绪障碍和嗜睡。自杀是最常见的严重事件。羟氯喹、氯喹和多西环素出现了6例意外不良事件。

结论

潜在的CNS不良事件不具有特异性,总体上可能与羟氯喹(单药治疗或与抗生素联用)的使用有关。数据证实了这些药物在预防和管理严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染体征和症状方面不利的风险/获益情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ee6/9595226/9152b6b0acc5/rpsp-46-e166_Figure1.jpg

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