Wei Mian, Li Toni, Liu Siyuan, Wang Yushu, Tran Carolyn, Ao Guangyu
Department of Nephrology, Chengdu First People's Hospital, China.
Division of Emergency Medicine, Department of Medicine, University of Toronto, Canada.
Jpn J Infect Dis. 2024 May 23;77(3):182-186. doi: 10.7883/yoken.JJID.2023.315. Epub 2024 Jan 31.
Nafamostat mesylate, a synthetic serine protease inhibitor, has been shown to have antiviral activity against SARS-CoV-2 and anticoagulant properties that may be beneficial in the treatment of COVID-19. We conducted a meta-analysis to evaluate the effectiveness and safety of nafamostat mesylate for the treatment of COVID-19. PubMed, Embase, Cochrane Library, Scopus, Web of Science, medRxiv, and bioRxiv were searched up to July 2023 for studies comparing the outcomes of nafamostat mesylate treatment and no nafamostat mesylate treatment in patients with COVID-19. Mortality, disease progression, and adverse events were analyzed. Six studies involving 16,195 patients were included in the analysis. Meta-analysis revealed no significant difference in mortality (odds ratio [OR]: 0.88, 95% CI: 0.20-3.75, P = 0.86) or disease progression (OR: 2.76, 95% CI: 0.31-24.68, P = 0.36) between groups. However, nafamostat mesylate was associated with an increased risk of hyperkalemia (OR: 7.15, 95% CI: 2.66-19.24, P < 0.0001). Nafamostat mesylate did not improve mortality or morbidity in hospitalized patients with COVID-19. The risk of hyperkalemia is a serious concern that requires monitoring and preventive measures. Further research in different COVID-19 populations is required.
甲磺酸萘莫司他是一种合成的丝氨酸蛋白酶抑制剂，已显示出对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）具有抗病毒活性以及抗凝特性，这可能对2019冠状病毒病（COVID-19）的治疗有益。我们进行了一项荟萃分析，以评估甲磺酸萘莫司他治疗COVID-19的有效性和安全性。截至2023年7月，我们在PubMed、Embase、Cochrane图书馆、Scopus、科学网、medRxiv和bioRxiv上检索了比较甲磺酸萘莫司他治疗与未使用甲磺酸萘莫司他治疗的COVID-19患者结局的研究。分析了死亡率、疾病进展和不良事件。六项涉及16195名患者的研究纳入了分析。荟萃分析显示，两组之间在死亡率（优势比[OR]：0.88，95%置信区间[CI]：0.20 - 3.75，P = 0.86）或疾病进展（OR：2.76，95% CI：0.31 - 24.68，P = 0.36）方面无显著差异。然而，甲磺酸萘莫司他与高钾血症风险增加相关（OR：7.15，95% CI：2.66 - 19.24，P < 0.0001）。甲磺酸萘莫司他并未改善住院COVID-19患者的死亡率或发病率。高钾血症风险是一个需要监测和采取预防措施的严重问题。需要在不同的COVID-19人群中进行进一步研究。
