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阿比朵尔治疗新型冠状病毒奥密克戎变异株的真实世界经验。

Real-world experience of arbidol for Omicron variant of SARS-CoV-2.

作者信息

Zhao Jingya, Li Yong, Chen Rong, Xu Yanping, Yang Qingyuan, Zhang Haiqing, Yin Zhengxin, Gu Weiting, Hu Jinsong, Chen Li, Li Jian, Ning Guang, Cheng Qijian, Zhou Min, Qu Jieming

机构信息

Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Institute of Respiratory Disease, Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

J Thorac Dis. 2023 Feb 28;15(2):452-461. doi: 10.21037/jtd-22-980. Epub 2023 Feb 5.

Abstract

BACKGROUND

At a crucial time with the rapid spread of Omicron severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus variant globally, we conducted a study to evaluate the efficacy and safety of arbidol tablets in the treatment of this variant.

METHODS

From Mar 26 to April 26, 2022, we conducted a prospective, open-labeled, controlled, and investigator-initiated trial involving adult patients with confirmed Omicron variant infection. Patients with asymptomatic or mild clinical status were stratified 1:2 to receive either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 5 days). The primary endpoint was the negative conversion rate within the first week.

RESULTS

A total of 367 patients were enrolled in the study; 246 received arbidol tablet treatment, and 121 were in the control group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group [47.2% (116/246) 35.5% (43/121); odds ratio (OR), 1.619; 95% confidence interval (CI): 1.034-2.535; P=0.035]. Compared to those in the SOC group, patients receiving arbidol tablets had a shorter negative conversion time [median 8.3 10.0 days; hazard ratio (HR), 0.645; 95% CI: 0.516-0.808; P<0.001], and a shorter duration of hospitalization (median 11.4 13.7 days; HR, 1.214; 95% CI: 0.966-1.526; P<0.001). Moreover, the addition of arbidol tablets led to better recovery of declined blood lymphocytes, CD3, CD4, and CD8 cell counts. The most common adverse event (AE) was transaminase elevation in patients treated with arbidol tablets (3/246, 1.2%). No one withdrew from the study due to AEs or disease progression.

CONCLUSIONS

As a whole, arbidol may represent an effective and safe treatment in asymptomatic-mild patients suffering from Omicron variant during the pandemic of coronavirus disease 2019 (COVID-19).

摘要

背景

在奥密克戎严重急性呼吸综合征冠状病毒2(SARS-CoV-2)变种在全球迅速传播的关键时期,我们开展了一项研究以评估阿比多尔片治疗该变种的疗效和安全性。

方法

2022年3月26日至4月26日,我们进行了一项前瞻性、开放标签、对照且由研究者发起的试验,纳入确诊感染奥密克戎变种的成年患者。无症状或临床症状轻微的患者按1:2分层,分别接受标准治疗(SOC)或SOC加阿比多尔片(每次口服200毫克,每日3次,共5天)。主要终点为第一周内的病毒转阴率。

结果

共有367例患者纳入研究;246例接受阿比多尔片治疗,121例为对照组。接受阿比多尔片治疗的患者第一周内SARS-CoV-2病毒转阴率显著高于SOC组[47.2%(116/246)对35.5%(43/121);优势比(OR)为1.619;95%置信区间(CI):1.034 - 2.535;P = 0.035]。与SOC组相比,接受阿比多尔片治疗的患者病毒转阴时间更短[中位数8.3对10.0天;风险比(HR)为0.645;95%CI:0.516 - 0.808;P < 0.001],住院时间也更短(中位数11.4对13.7天;HR为1.214;95%CI:0.966 - 1.526;P < 0.001)。此外,加用阿比多尔片可使下降的血液淋巴细胞、CD3、CD4和CD8细胞计数恢复得更好。最常见的不良事件(AE)是接受阿比多尔片治疗患者的转氨酶升高(3/246,1.2%)。无人因AE或疾病进展退出研究。

结论

总体而言,在2019冠状病毒病(COVID-19)大流行期间,阿比多尔可能是治疗感染奥密克戎变种的无症状 - 轻症患者的一种有效且安全的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01d0/9992600/f011947a2848/jtd-15-02-452-f1.jpg

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