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去铁胺用于ICU收治的COVID-19成年患者的治疗:一项前瞻性观察性队列研究。

Deferoxamine in the management of COVID-19 adult patients admitted to ICU: a prospective observational cohort study.

作者信息

Almutary Abdulaziz M, Althunayyan Saqer, Bagalb Amal S, Mady Ahmed F, Alenazi Latifa, Mumtaz Shahzad A, Al-Hammad Zahrah, Abdulrahman Basheer, Al-Odat Mohammed A, Mhawish Huda, Aletreby Waleed Th, Altartouri Maymouna, Memish Ziad A

机构信息

Departments of Emergency.

Department of Accident and Trauma, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University.

出版信息

Ann Med Surg (Lond). 2023 Apr 12;85(5):1468-1474. doi: 10.1097/MS9.0000000000000392. eCollection 2023 May.

Abstract

UNLABELLED

COVID-19 infection is associated with high mortality, and despite extensive studying the scientific society is still working to find a definitive treatment. Some experts postulated a beneficial role of Deferoxamine.

AIM

The aim of this study was to compare the outcomes of COVID-19 adult patients admitted to the ICU who received deferoxamine to those who received standard of care.

METHODS

Prospective observational cohort study, in the ICU of a tertiary referral hospital in Saudi Arabia to compare all-cause hospital mortality between COVID-19 patients who received deferoxamine and standard of care.

RESULTS

A total of 205 patients were enrolled, with an average age of 50.1±14.3, 150 patients received standard of care only, and 55 patients received deferoxamine additionally. Hospital mortality was lower in deferoxamine group (25.5 vs. 40.7%, 95% CI=1.3-29.2%; =0.045). Clinical status score upon discharge was lower in deferoxamine group (3.6±4.3 vs. 6.2±4, 95% CI: 1.4-3.9; <0.001), as was the difference between discharge score and admission score (indicating clinical improvement). More patients admitted with mechanical ventilation were successfully extubated in the deferoxamine group (61.5 vs. 14.3%, 95% CI: 15-73%; =0.001), with a higher median ventilator-free days. There were no differences between groups in adverse events. Deferoxamine group was associated with hospital mortality [odds ratio=0.46 (95% CI: 0.22-0.95); =0.04].

CONCLUSIONS

Deferoxamine may have mortality and clinical improvement benefits in COVID-19 adults admitted to ICU. Further powered and controlled studies are required.

摘要

未标注

新型冠状病毒肺炎(COVID-19)感染与高死亡率相关,尽管进行了广泛研究,但科学界仍在努力寻找确切的治疗方法。一些专家推测去铁胺具有有益作用。

目的

本研究旨在比较入住重症监护病房(ICU)的成年COVID-19患者中接受去铁胺治疗者与接受标准治疗者的结局。

方法

前瞻性观察性队列研究,在沙特阿拉伯一家三级转诊医院的ICU中比较接受去铁胺治疗的COVID-19患者与接受标准治疗的患者的全因住院死亡率。

结果

共纳入205例患者,平均年龄50.1±14.3岁,150例患者仅接受标准治疗,55例患者额外接受去铁胺治疗。去铁胺组的医院死亡率较低(25.5%对40.7%,95%置信区间=1.3 - 29.2%;P=0.045)。去铁胺组出院时的临床状态评分较低(3.6±4.3对6.2±4,95%置信区间:1.4 - 3.9;P<0.001),出院评分与入院评分之间的差异(表明临床改善)也是如此。去铁胺组中更多接受机械通气入院的患者成功脱机(61.5%对14.3%,95%置信区间:15 - 73%;P=0.001),无呼吸机天数中位数更高。两组不良事件无差异。去铁胺组与医院死亡率相关[比值比=0.46(95%置信区间:0.22 - 0.95);P=0.04]。

结论

去铁胺可能对入住ICU的成年COVID-19患者有降低死亡率和改善临床状况的益处。需要进一步开展有足够样本量和对照的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/024d/10205239/269bf1c58662/ms9-85-1468-g001.jpg

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