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瑞德西韦和皮质类固醇治疗住院 COVID-19 患者。

Remdesivir and corticosteroids in the treatment of hospitalized COVID-19 patients.

机构信息

Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.

NOVA Medical School, CHRC, New University of Lisbon, Lisbon, Portugal.

出版信息

Sci Rep. 2023 Mar 18;13(1):4482. doi: 10.1038/s41598-023-31544-5.

Abstract

Coronavirus disease 2019 (COVID-19) is a pandemic infection caused by the newly discovered severe acute respiratory syndrome coronavirus 2. Remdesivir (RDV) and corticosteroids are used mainly in COVID-19 patients with acute respiratory failure. The main objective of the study was to assess the effectiveness of remdesivir with and without corticosteroids in the treatment of COVID-19 patients. We conducted a prospective observational study, including adult patients consecutively hospitalized with confirmed COVID-19 and acute respiratory failure. Patients were divided according to treatment strategy: RDV alone versus RDV with corticosteroids. The primary outcome was the time to recovery in both treatment groups. We included 374 COVID-19 adult patients, 184 were treated with RDV, and 190 were treated with RDV and corticosteroid. Patients in the RDV group had a shorter time to recovery in comparison with patients in the RDV plus corticosteroids group at 28 days after admission [11 vs. 16 days (95% confidence Interval 9.7-12.8; 14.9-17.1; p = .016)]. Patients treated with RDV alone had a shorter length of hospital stay. The use of corticosteroids as adjunctive therapy of RDV was not associated with improvement in mortality of COVID-19 patients.

摘要

2019 年冠状病毒病(COVID-19)是由新发现的严重急性呼吸综合征冠状病毒 2 引起的大流行感染。瑞德西韦(RDV)和皮质类固醇主要用于 COVID-19 急性呼吸衰竭患者。本研究的主要目的是评估 RDV 联合和不联合皮质类固醇治疗 COVID-19 患者的疗效。我们进行了一项前瞻性观察性研究,纳入了连续住院的确诊 COVID-19 和急性呼吸衰竭的成年患者。根据治疗策略将患者分为:RDV 单药治疗与 RDV 联合皮质类固醇治疗。主要结局是两组患者的恢复时间。我们共纳入 374 例 COVID-19 成年患者,184 例接受 RDV 治疗,190 例接受 RDV 联合皮质类固醇治疗。与 RDV 联合皮质类固醇组相比,RDV 组患者在入院后 28 天内的恢复时间更短[11 天 vs. 16 天(95%置信区间 9.7-12.8;14.9-17.1;p=0.016)]。RDV 单药治疗组患者的住院时间更短。皮质类固醇作为 RDV 的辅助治疗与 COVID-19 患者死亡率的改善无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f1/10024735/b7ca0997c155/41598_2023_31544_Fig1_HTML.jpg

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