阿兹夫定对降低新冠病毒感染患者死亡率的疗效。
Azvudine efficacy in reducing mortality in COVID-19 patients.
作者信息
Zhong Zhen, Liu Xiao-Feng, Zhou Xiao-Zhong, Zhong Jia-Ning, Zhou Li-Cheng, Li Rong, Liu Xian-Fa
机构信息
Department of Emergency, First Affiliated Hospital of Gannan Medical University, 128 Jinling Road, Zhanggong District, Ganzhou City, Jiangxi Province, China.
Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China.
出版信息
Eur J Med Res. 2024 Dec 26;29(1):625. doi: 10.1186/s40001-024-02220-9.
BACKGROUND
Several therapeutic drugs have been authorized for the treatment of patients with Coronavirus disease 2019 (COVID-19). However, further research on the mechanisms of action, efficacy, and target populations of these novel therapeutic drugs are necessary. This study included mild, moderate, severe, and critical COVID-19 patients to evaluate azvudine's effectiveness across different severity levels.
METHODS
We conducted a retrospective cohort study of patients with COVID-19 admitted to our hospital from December 1, 2022, to March 31, 2023. Patients were divided into retrospective cohorts receiving azvudine antiviral therapy and standard treatment, and were followed-up for up to 28 days.
RESULTS
Prior to data processing, azvudine treatment was associated with reduced mortality rates at 7 days (1.09/1000 persons vs. 5.06/1000 persons, P < 0.001) and 14 days (3.35/1000 persons vs. 5.65/1000 persons, P = 0.001). After propensity score matching, a decrease in mortality rates at 7 days (0.8/1000 persons vs. 6.29/1000 persons, P < 0.001), 14 days (3.42/1000 persons vs. 7.26/1000 persons, P < 0.001), and 28 days (4.33/1000 persons vs. 7.29/1000 persons, P = 0.003) were observed following azvudine treatment. After inverse probability of treatment weighting adjustment, the results were consistent with propensity score matching. In the clinical subgroup analysis, azvudine treatment intervention significantly reduced the 7-day (2.49/1000 persons vs. 14.59/1000 persons, P = 0.001 and 11.36/1000 persons vs. 66.99/1000 persons, P < 0.001), 14-day (5.22/1000 persons vs. 17.36/1000 persons, P < 0.001 and 17.08/1000 persons vs. 51.72/1000 persons, P = 0.002), and 28-day (7.58/1000 persons vs. 16.02/1000 persons, P = 0.014 and 20.43/1000 persons vs. 46.51/1000 persons, P = 0.008) mortality rates in hospitalized patients with severe and critical COVID-19.
CONCLUSIONS
The study suggests that in hospitalized patients with COVID-19, azvudine treatment significantly reduces patient mortality rates in hospitalized COVID-19 infections, wherein the effects are more pronounced in severe and critical patients.
背景
已有几种治疗药物被批准用于治疗2019冠状病毒病（COVID-19）患者。然而，有必要对这些新型治疗药物的作用机制、疗效和目标人群进行进一步研究。本研究纳入了轻度、中度、重度和危重型COVID-19患者，以评估阿兹夫定在不同严重程度水平下的有效性。
方法
我们对2022年12月1日至2023年3月31日期间我院收治的COVID-19患者进行了一项回顾性队列研究。患者被分为接受阿兹夫定抗病毒治疗和标准治疗的回顾性队列，并随访长达28天。
结果
在数据处理之前，阿兹夫定治疗与7天（1.09/1000人 vs. 5.06/1000人，P<0.001）和14天（3.35/1000人 vs. 5.65/1000人，P=0.001）的死亡率降低相关。倾向得分匹配后，观察到阿兹夫定治疗后7天（0.8/1000人 vs. 6.29/1000人，P<0.001）、14天（3.42/1000人 vs. 7.26/1000人，P<0.001）和28天（4.33/1000人 vs. 7.29/1000人，P=0.003）的死亡率下降。经过治疗权重逆概率调整后，结果与倾向得分匹配一致。在临床亚组分析中，阿兹夫定治疗干预显著降低了住院的重度和危重型COVID-19患者的7天（2.49/1000人 vs. 14.59/1000人，P=0.001和 11.36/1000人 vs. 66.99/1000人，P<0.001）、14天（5.22/1000人 vs. 17.36/1000人，P<0.001和17.08/1000人 vs. 51.72/1000人，P=0.002）和28天（7.58/1000人 vs. 16.02/1000人，P=0.014和20.43/1000人 vs. 46.51/1000人，P=0.008）死亡率。
结论
该研究表明，在住院的COVID-19患者中，阿兹夫定治疗可显著降低COVID-19住院感染患者的死亡率，其中在重度和危重型患者中效果更为显著。
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