奥司他韦用于危重症COVID-19患者的效果：一项多中心倾向评分匹配研究。
The effect of oseltamivir use in critically ill patients with COVID-19: A multicenter propensity score-matched study.
作者信息
Aljuhani Ohoud, Korayem Ghazwa B, Altebainawi Ali F, Alotaibi Meshal S, Alrakban Noura A, Ghoneim Ragia H, Vishwakarma Ramesh, Al Shaya Abdulrahman I, Al Harbi Shmeylan, Gramish Jawaher, Almutairi Dahlia M, Alqannam Ghada, Alamri Faisal F, Alharthi Abdullah F, Alfaifi Mashael, Al Amer Abdullah, Alenazi Abeer A, Bin Aydan Norah, Alalawi Mai, Al Sulaiman Khalid
机构信息
Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, P.O.Box 84428, Riyadh 11671, Saudi Arabia.
出版信息
Saudi Pharm J. 2023 Jul;31(7):1210-1218. doi: 10.1016/j.jsps.2023.05.006. Epub 2023 May 23.
BACKGROUND
Oseltamivir has been used as adjunctive therapy in the management of patients with COVID-19. However, the evidence about using oseltamivir in critically ill patients with severe COVID-19 remains scarce. This study aims to evaluate the effectiveness and safety of oseltamivir in critically ill patients with COVID-19.
METHODS
This multicenter, retrospective cohort study includes critically ill adult patients with COVID-19 admitted to the intensive care unit (ICU). Patients were categorized into two groups based on oseltamivir use within 48 hours of ICU admission (Oseltamivir vs. Control). The primary endpoint was viral load clearance.
RESULTS
A total of 226 patients were matched into two groups based on their propensity score. The time to COVID-19 viral load clearance was shorter in patients who received oseltamivir (11 vs. 16 days, p = 0.042; beta coefficient: -0.84, 95%CI: (-1.33, 0.34), p = 0.0009). Mechanical ventilation (MV) duration was also shorter in patients who received oseltamivir (6.5 vs. 8.5 days, p = 0.02; beta coefficient: -0.27, 95% CI: [-0.55,0.02], P = 0.06). In addition, patients who received oseltamivir had lower odds of hospital/ventilator-acquired pneumonia (OR:0.49, 95% CI:(0.283,0.861), p = 0.01). On the other hand, there were no significant differences between the groups in the 30-day and in-hospital mortality.
CONCLUSION
Oseltamivir was associated with faster viral clearance and shorter MV duration without safety concerns in critically ill COVID-19 patients.
背景
奥司他韦已被用作新型冠状病毒肺炎（COVID-19）患者管理的辅助治疗药物。然而，关于在重症COVID-19患者中使用奥司他韦的证据仍然很少。本研究旨在评估奥司他韦在重症COVID-19患者中的有效性和安全性。
方法
这项多中心回顾性队列研究纳入了入住重症监护病房（ICU）的成年重症COVID-19患者。根据患者在入住ICU后48小时内是否使用奥司他韦将其分为两组（奥司他韦组与对照组）。主要终点是病毒载量清除。
结果
根据倾向评分，共有226例患者被匹配到两组中。接受奥司他韦治疗的患者COVID-19病毒载量清除时间更短（11天对16天，p = 0.042；β系数：-0.84，95%CI：[-1.33, 0.34]，p = 0.0009）。接受奥司他韦治疗的患者机械通气（MV）持续时间也更短（6.5天对8.5天，p = 0.02；β系数：-0.27，95%CI：[-0.55, 0.02]，P = 0.06）。此外，接受奥司他韦治疗的患者发生医院/呼吸机相关性肺炎的几率较低（OR：0.49，95%CI：(0.283, 0.861)，p = 0.01）。另一方面，两组在30天和住院死亡率方面没有显著差异。
结论
在重症COVID-19患者中，奥司他韦与更快的病毒清除和更短的MV持续时间相关，且无安全性问题。
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