帕克洛维德治疗 COVID-19：系统评价和荟萃分析。

Paxlovid for the treatment of COVID-19: a systematic review and meta-analysis.

机构信息

Department of Cardiology, Shidong Hospital, Yangpu District, Shidong Hospital affiliated to University of Shanghai for Science and Technology, 999 Shiguang Road, Shanghai 200438, China.

School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.

出版信息

J Infect Dev Ctries. 2024 Aug 31;18(8):1169-1178. doi: 10.3855/jidc.19202.

DOI:10.3855/jidc.19202

PMID:39288386

Abstract

INTRODUCTION

Paxlovid (nirmatrelvir/ritonavir) is a new oral antiviral drug that is used for coronavirus disease 2019 (COVID-19) and is administered to patients with mild to moderate disease for five consecutive days. This meta-analysis aimed to evaluate the efficacy of Paxlovid in COVID-19 patients.

METHODOLOGY

PubMed, Embase, Cochrane Library, and Web of Science databases were searched to identify relevant publications up to 9 March 2023. Three randomized controlled trial (RCT) studies, one prospective cohort study, and 25 retrospective cohort studies were identified for the meta-analysis.

RESULTS

There was a significant difference between the Paxlovid and control groups in terms of hospitalization (RR = 0.53; 95% CI: 0.24-0.69, p < 0.001), all-cause mortality (RR = 0.36; 95% CI: 0.27-0.50, p < 0.001), hospitalization or death (RR = 0.50; 95% CI: 0.37-0.67, p < 0.001), intensive care unit admission (RR = 0.45; 95% CI: 0.27-0.73, p = 0.001), and emergency department visits (RR = 0.67; 95% CI: 0.54-0.83, p < 0.001). However, no significant difference was found between the two groups in terms of COVID-19 rebound (OR = 1.18; 95% CI: 0.82-1.68, p = 0.37). In addition, the Paxlovid group had a significantly shorter hospital length of stay (weighted mean difference WMD = -1.11; 95% CI, -1.81, -0.41; I2 > 50%, p < 0.05), and polymerase chain reaction negative conversion time (WMD = -2.75; 95% CI, -3.60, -1.89, I2 > 50%, p < 0.05) than that of the control group.

CONCLUSIONS

Paxlovid can be considered an effective therapeutic agent for treating patients with COVID-19.

摘要

简介

帕克洛维（尼马曲韦/利托那韦）是一种新的口服抗病毒药物，用于治疗 2019 年冠状病毒病（COVID-19），并给患有轻度至中度疾病的患者连续五天使用。本荟萃分析旨在评估帕克洛维在 COVID-19 患者中的疗效。

方法

检索了 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库，以确定截至 2023 年 3 月 9 日的相关文献。对 3 项随机对照试验（RCT）研究、1 项前瞻性队列研究和 25 项回顾性队列研究进行了荟萃分析。

结果

与对照组相比，帕克洛维组在住院治疗（RR=0.53；95%CI：0.24-0.69，p<0.001）、全因死亡率（RR=0.36；95%CI：0.27-0.50，p<0.001）、住院或死亡（RR=0.50；95%CI：0.37-0.67，p<0.001）、重症监护病房入住率（RR=0.45；95%CI：0.27-0.73，p=0.001）和急诊就诊率（RR=0.67；95%CI：0.54-0.83，p<0.001）方面均有显著差异。然而，两组 COVID-19 反弹率（OR=1.18；95%CI：0.82-1.68，p=0.37）无显著差异。此外，帕克洛维组的住院时间（加权均数差 WMD=-1.11；95%CI，-1.81，-0.41；I2>50%，p<0.05）和聚合酶链反应阴性转换时间（WMD=-2.75；95%CI，-3.60，-1.89，I2>50%，p<0.05）均显著短于对照组。