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瑞德西韦治疗对需要高流量补充氧或有创机械通气的住院成年 COVID-19 患者的死亡率降低没有效果。

Remdesivir Treatment Lacks the Effect on Mortality Reduction in Hospitalized Adult COVID-19 Patients Who Required High-Flow Supplemental Oxygen or Invasive Mechanical Ventilation.

机构信息

Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan.

Department of Nursing, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan.

出版信息

Medicina (Kaunas). 2023 May 26;59(6):1027. doi: 10.3390/medicina59061027.

Abstract

: The therapeutic impact of remdesivir on hospitalized adult COVID-19 patients is unknown. The purpose of this meta-analysis was to compare the mortality outcomes of hospitalized adult COVID-19 patients receiving remdesivir therapy to those of patients receiving a placebo based on their oxygen requirements. : The clinical status of the patients was assessed at the start of treatment using an ordinal scale. Studies comparing the mortality rate of hospitalized adults with COVID-19 treated with remdesivir vs. those treated with a placebo were included. : Nine studies were included and showed that the risk of mortality was reduced by 17% in patients treated with remdesivir. Hospitalized adult COVID-19 patients who did not require supplemental oxygen or who required low-flow oxygen and were treated with remdesivir had a lower mortality risk. In contrast, hospitalized adult patients who required high-flow supplemental oxygen or invasive mechanical ventilation did not have a therapeutic benefit in terms of mortality. : The clinical benefit of mortality reduction in hospitalized adult COVID-19 patients treated with remdesivir was associated with no need for supplemental oxygen or requiring supplemental low-flow oxygen at the start of treatment, especially in those requiring supplemental low-flow oxygen.

摘要

瑞德西韦治疗住院成年 COVID-19 患者的疗效尚不清楚。本荟萃分析的目的是比较根据氧需求接受瑞德西韦治疗的住院成年 COVID-19 患者与接受安慰剂治疗的患者的死亡率结局。在开始治疗时,使用序数量表评估患者的临床状况。纳入了比较接受瑞德西韦治疗与接受安慰剂治疗的住院成人 COVID-19 患者死亡率的研究。纳入了 9 项研究,结果表明瑞德西韦治疗组患者的死亡率降低了 17%。未需要补充氧气或仅需要低流量氧气且接受瑞德西韦治疗的住院成年 COVID-19 患者的死亡率风险较低。相比之下,需要高流量补充氧气或有创机械通气的住院成年患者在死亡率方面没有治疗获益。瑞德西韦治疗住院成年 COVID-19 患者可降低死亡率的临床获益与治疗开始时无需补充氧气或仅需要补充低流量氧气相关,尤其是需要补充低流量氧气的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca2a/10301784/94c6642c7ef2/medicina-59-01027-g001.jpg

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