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奥司他韦(达菲)治疗 2019 年冠状病毒病(COVID-19)的疗效和安全性的系统评价和荟萃分析。

Systematic review and meta-analysis of the efficacy and safety of oseltamivir (Tamiflu) in the treatment of Coronavirus Disease 2019 (COVID-19).

机构信息

Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.

Department of Microbiology, Faculty of Sciences, Federal University Birnin Kebbi, Birnin Kebbi, Nigeria.

出版信息

PLoS One. 2022 Dec 1;17(12):e0277206. doi: 10.1371/journal.pone.0277206. eCollection 2022.

Abstract

Efforts are ongoing by researchers globally to develop new drugs or repurpose existing ones for treating COVID-19. Thus, this led to the use of oseltamivir, an antiviral drug used for treating influenza A and B viruses, as a trial drug for COVID-19. However, available evidence from clinical studies has shown conflicting results on the effectiveness of oseltamivir in COVID-19 treatment. Therefore, this systematic review and meta-analysis was performed to assess the clinical safety and efficacy of oseltamivir for treating COVID-19. The study was conducted according to the PRISMA guidelines, and the priori protocol was registered in PROSPERO (CRD42021270821). Five databases were searched, the identified records were screened, and followed by the extraction of relevant data. Eight observational studies from four Asian countries were included. A random-effects model was used to pool odds ratios (ORs), mean differences (MD), and their 95% confidence intervals (CI) for the study analysis. Survival was not significantly different between all categories of oseltamivir and the comparison groups analysed. The duration of hospitalisation was significantly shorter in the oseltamivir group following sensitivity analysis (MD -5.95, 95% CI -9.91--1.99 p = 0.003, heterogeneity I2 0%, p = 0.37). The virological, laboratory and radiological response rates were all not in favour of oseltamivir. However, the electrocardiographic safety parameters were found to be better in the oseltamivir group. However, more studies are needed to establish robust evidence on the effectiveness or otherwise of oseltamivir usage for treating COVID-19.

摘要

全球研究人员正在努力开发新的药物或重新利用现有的药物来治疗 COVID-19。因此,这导致了抗病毒药物奥司他韦被用作 COVID-19 的试验药物,该药物用于治疗甲型和乙型流感病毒。然而,来自临床研究的现有证据表明,奥司他韦在 COVID-19 治疗中的有效性存在相互矛盾的结果。因此,进行了这项系统评价和荟萃分析,以评估奥司他韦治疗 COVID-19 的临床安全性和疗效。该研究按照 PRISMA 指南进行,预先方案在 PROSPERO(CRD42021270821)中进行了注册。共检索了 5 个数据库,筛选了确定的记录,并随后提取了相关数据。纳入了来自四个亚洲国家的八项观察性研究。使用随机效应模型对所有类别奥司他韦和分析比较组的优势比(OR)、均值差异(MD)及其 95%置信区间(CI)进行了汇总。所有奥司他韦类别与分析比较组之间的生存率无显著差异。敏感性分析显示,奥司他韦组的住院时间明显缩短(MD-5.95,95%CI-9.91--1.99,p=0.003,异质性 I2 0%,p=0.37)。病毒学、实验室和影像学反应率均不利于奥司他韦。然而,奥司他韦组的心电图安全性参数更好。然而,需要更多的研究来建立关于奥司他韦治疗 COVID-19 的有效性或其他方面的可靠证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7164/9714710/914ba2fbe073/pone.0277206.g001.jpg

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