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莫努匹韦治疗奥密克戎变异株流行期间成年患者轻至中度 COVID-19 的真实世界临床结局:一项荟萃分析

Real-World Clinical Outcomes of Molnupiravir for the Treatment of Mild to Moderate COVID-19 in Adult Patients during the Dominance of the Omicron Variant: A Meta-Analysis.

作者信息

Huang Chienhsiu, Lu Tsung-Lung, Lin Lichen

机构信息

Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, NO. 2, Min-Sheng Road, Dalin Town, Chiayi 62247, Taiwan.

Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, NO. 2, Min-Sheng Road, Dalin Town, Chiayi 62247, Taiwan.

出版信息

Antibiotics (Basel). 2023 Feb 15;12(2):393. doi: 10.3390/antibiotics12020393.

DOI:10.3390/antibiotics12020393
PMID:36830302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9952148/
Abstract

INTRODUCTION

The therapeutic impact of molnupiravir in the Omicron variant phase is unknown. The goal of the current meta-analysis was to compare the real-world clinical outcomes of molnupiravir for the treatment of mild to moderate COVID-19 during the dominance of the Omicron variant in adult patients to that of a placebo.

METHODS

To be included, studies had to directly compare the clinical effectiveness of molnupiravir in treating adult COVID-19 patients to that of a placebo. Studies were included based on the following outcomes: all-cause mortality, composite outcome of disease progression, hospitalization rate, and viral load.

RESULTS

The current meta-analysis included six studies that indicated that the risk of mortality was reduced by 34%, and the risk of composite outcome of disease progression was reduced by 37% among patients who received molnupiravir. Molnupiravir was associated with faster reduction in viral loads than the placebo. There was no clinical benefit of reducing all-cause mortality in mild to moderate COVID-19 patients with high COVID-19 vaccination coverage.

CONCLUSION

The clinical effectiveness of molnupiravir was associated with COVID-19 vaccination coverage in COVID-19 patients. There is a lack of detailed data on its effectiveness in vaccinated patients, especially those with low COVID-19 vaccination coverage.

摘要

引言

莫努匹拉韦在奥密克戎变异株流行阶段的治疗效果尚不清楚。本荟萃分析的目的是比较在奥密克戎变异株占主导期间,莫努匹拉韦治疗成年患者轻至中度新冠肺炎的真实世界临床结局与安慰剂的临床结局。

方法

纳入的研究必须直接比较莫努匹拉韦治疗成年新冠肺炎患者与安慰剂的临床疗效。根据以下结局纳入研究:全因死亡率、疾病进展复合结局、住院率和病毒载量。

结果

当前的荟萃分析纳入了六项研究,这些研究表明,接受莫努匹拉韦治疗的患者死亡率风险降低了34%,疾病进展复合结局风险降低了37%。与安慰剂相比,莫努匹拉韦可使病毒载量更快下降。在新冠疫苗接种率高的轻至中度新冠肺炎患者中,降低全因死亡率并无临床益处。

结论

莫努匹拉韦的临床疗效与新冠肺炎患者的新冠疫苗接种率有关。缺乏关于其在接种疫苗患者中有效性的详细数据,尤其是新冠疫苗接种率低的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/71910ac66517/antibiotics-12-00393-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/d314a2cbd875/antibiotics-12-00393-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/fe5815d8ac71/antibiotics-12-00393-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/cf9150fc5c73/antibiotics-12-00393-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/d178a246e429/antibiotics-12-00393-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/dbb00b19677e/antibiotics-12-00393-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/a1be8293906c/antibiotics-12-00393-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/71910ac66517/antibiotics-12-00393-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/d314a2cbd875/antibiotics-12-00393-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/fe5815d8ac71/antibiotics-12-00393-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/cf9150fc5c73/antibiotics-12-00393-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/d178a246e429/antibiotics-12-00393-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/dbb00b19677e/antibiotics-12-00393-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/a1be8293906c/antibiotics-12-00393-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9366/9952148/71910ac66517/antibiotics-12-00393-g007.jpg

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