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SARS-CoV-2患者中类固醇使用与二重感染之间的关系。一项系统评价和荟萃分析。

Relationship between steroid use and superinfections in SARS-CoV-2 patients. A systematic review and meta-analysis.

作者信息

González Ramírez Melissa, Hoyos Muñoz Jaime Andrés, Moreno Gómez Germán Alberto, Aguirre Flórez Mateo, Gómez González José Fernando

机构信息

Medical Doctor; Specialist in critical medicine and intensive care. Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.

Medical Doctor; Clinical Epidemiologist. Ph.D. in Public Health. Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.

出版信息

Infect Ecol Epidemiol. 2023 Nov 27;13(1):2277000. doi: 10.1080/20008686.2023.2277000. eCollection 2023.

DOI:10.1080/20008686.2023.2277000
PMID:38187166
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10769522/
Abstract

The use of steroids has been proposed as a pharmacological approach to treat the SARS-CoV-2 infection to improve outcomes. However, there are doubts about safety against the development of superinfections and their worse outcomes. To establish the relative frequency of superinfection associated with using steroids in patients with SARS-CoV-2 infection. We conducted a systematic literature review and meta-analysis using PRISMA standards in 5 databases (PubMed/Scopus/Cochrane/EMBASE/Google Scholar). The search was carried out between February 2020 and May 2023. The search terms were 'steroids' or 'superinfection' 'and' followed by 'SARS-CoV-2' or 'COVID-19'. We found 77 studies, but only 10 with 3539 patients were included in the systematic review. All patients developed severe disease. The documented OR for superinfection through the meta-analysis was 1.437 (95% IC 0.869-2.378) with a p-value of 0.158 without showing a risk attributed to steroids and the development of superinfections. In the Funnel-plot analysis, no publication biases were found. No relationship was found between using steroids and superinfection in patients with SARS-CoV-2.

摘要

有人提议使用类固醇作为一种药理学方法来治疗SARS-CoV-2感染以改善预后。然而，对于其在预防二重感染及其不良后果方面的安全性存在疑虑。为确定SARS-CoV-2感染患者中与使用类固醇相关的二重感染的相对频率，我们按照PRISMA标准在5个数据库（PubMed/Scopus/Cochrane/EMBASE/谷歌学术）中进行了系统的文献综述和荟萃分析。检索在2020年2月至2023年5月期间进行。检索词为“类固醇”或“二重感染”以及“SARS-CoV-2”或“COVID-19”。我们找到了77项研究，但只有10项涉及3539名患者的研究被纳入系统综述。所有患者均患有重症疾病。通过荟萃分析记录的二重感染的比值比为1.437（95%置信区间0.869 - 2.378），p值为0.158，未显示出类固醇使用与二重感染发生之间存在风险。在漏斗图分析中，未发现发表偏倚。在SARS-CoV-2感染患者中，未发现使用类固醇与二重感染之间存在关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3423/10769522/488b003d961f/ZIEE_A_2277000_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3423/10769522/863dffa24853/ZIEE_A_2277000_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3423/10769522/4728f6eacfed/ZIEE_A_2277000_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3423/10769522/488b003d961f/ZIEE_A_2277000_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3423/10769522/863dffa24853/ZIEE_A_2277000_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3423/10769522/4728f6eacfed/ZIEE_A_2277000_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3423/10769522/488b003d961f/ZIEE_A_2277000_F0003_OC.jpg

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本文引用的文献

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Efficacy and safety of systematic corticosteroids among severe COVID-19 patients: a systematic review and meta-analysis of randomized controlled trials.系统使用皮质类固醇治疗重症 COVID-19 患者的疗效和安全性：一项随机对照试验的系统评价和荟萃分析。
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