Feng Ting, Zhang Xin, Sun Yin, Yang Jingyu, Du Hengjian, Guo Jianshu, Tang Rongzhen
Department of Geriatric Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P.R. China.
Department of Laboratory Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P.R. China.
Exp Ther Med. 2022 Oct 31;24(6):736. doi: 10.3892/etm.2022.11672. eCollection 2022 Dec.
Arbidol (ARB) is efficacious for the treatment of influenza, and has been recommended for COVID-19. The present systematic review was performed to assess the existing knowledge on ARB therapy for acute respiratory viral infections, especially COVID-19. Subsequently, six databases were searched for publications reporting clinical outcomes of ARB therapy, and registered clinical trials up to May 6, 2022. The available literature was rigorously appraised. Based on the inclusion and exclusion criteria, 20 articles were identified for the final review. The result of meta-analysis showed that there was no significant difference in the negative rate of PCR day 7 [risk ratio (RR), 1.1; 95% CI, 0.87-1.40], negative rate of PCR day 14 (RR, 1.24; 95% CI, 0.92-1.67), PCR negative conversion time [mean difference (MD), -0.26; 95% CI, -1.41-0.90], time of clinical improvement (MD, 1.11; 95% CI, 0.01-2.22), hospital stay (MD, 0.16; 95% CI, -1.62-1.93), rate of improvement on chest computed tomography (CT) (RR, 1.19; 95% CI, 0.74-1.91), duration of CT absorption (MD, -1.43; 95% CI, -10.28-7.42), disease progression (RR, 1.05; 95% CI, 0.64-1.71) and mortality (RR, 0.68; 95% CI, 0.42-1.11). ARB demonstrated significant difference in the rate of clinical improvement (RR, 0.81; 95% CI, 0.67-0.97), duration of fever (MD, -0.38; 95% CI, -0.74- -0.02) and adverse events (RR, 0.65; 95% CI, 0.45-0.94). Although past clinical studies indicates notable results of ARB on influenza, there is no consensus on the drug for therapeutic and prophylaxis of COVID-19. The safety of ARB should be carefully monitored. High quality randomized controlled studies are urgently needed to thoroughly evaluate the efficacy and safety of ARB in patients with acute respiratory viral infections, especially COVID-19.
阿比朵尔(ARB)对流感治疗有效,已被推荐用于治疗新型冠状病毒肺炎(COVID-19)。本系统评价旨在评估有关ARB治疗急性呼吸道病毒感染,尤其是COVID-19的现有知识。随后,检索了六个数据库,以查找报告ARB治疗临床结果的出版物以及截至2022年5月6日注册的临床试验。对现有文献进行了严格评估。根据纳入和排除标准,确定了20篇文章进行最终综述。荟萃分析结果显示,第7天核酸检测阴性率[风险比(RR)为1.1;95%置信区间(CI)为0.87 - 1.40]、第14天核酸检测阴性率(RR为1.24;95%CI为0.92 - 1.67)、核酸转阴时间[平均差(MD)为 - 0.26;95%CI为 - 1.41 - 0.90]、临床改善时间(MD为1.11;95%CI为0.01 - 2.22)、住院时间(MD为0.16;95%CI为 - 1.62 - 1.93)、胸部计算机断层扫描(CT)改善率(RR为1.19;95%CI为0.74 - 1.91)、CT吸收持续时间(MD为 - 1.43;95%CI为 - 10.28 - 7.42)、疾病进展(RR为1.05;95%CI为0.64 - 1.71)和死亡率(RR为0.68;95%CI为0.42 - 1.11)方面均无显著差异。ARB在临床改善率(RR为0.81;95%CI为0.67 - 0.97)、发热持续时间(MD为 - 0.38;95%CI为 - 0.74 - - 0.02)和不良事件(RR为0.65;95%CI为0.45 - 0.94)方面显示出显著差异。尽管过去的临床研究表明ARB对流感有显著疗效,但对于其用于COVID-19的治疗和预防尚无共识。应密切监测ARB的安全性。迫切需要高质量的随机对照研究来全面评估ARB在急性呼吸道病毒感染患者,尤其是COVID-19患者中的疗效和安全性。