Saif-Ur-Rahman K M, Kothari Kavita, Sadlier Corinna, Moriarty Frank, Movsisyan Ani, Whelan Sean, Taneri Petek E, Blair Matthew, Guyatt Gordon, Devane Declan
Evidence Synthesis Ireland and Cochrane Ireland University of Galway Galway Ireland.
School of Nursing and Midwifery University of Galway Galway Ireland.
Cochrane Evid Synth Methods. 2023 Mar 20;1(1):e12001. doi: 10.1002/cesm.12001. eCollection 2023 Mar.
Little is known about the treatment of post-coronavirus disease 2019 (COVID-19) condition (PCC). This article examines the effectiveness of pharmacological interventions for treating people with PCC.
We searched Medline, EMBASE, ClinicalTrials. gov, and the International Clinical Trials Registry Platform. Two independent review authors screened citations, extracted data, and assessed the quality of the included studies. Due to heterogeneity in participants, interventions, and outcomes, we synthesized data narratively. We assessed the certainty of evidence using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation).
People with PCC.
Pharmacological interventions include corticosteroids, ivabradine, and inhaled hydrogen.
Olfactory function, sinus tachycardia, respiratory function.
We identified 5 completed studies and 41 ongoing studies. Oral corticosteroids and olfactory training had higher olfactory scores after 10 weeks (MD: 5.60, 95% confidence interval [CI]: 1.41 to 9.79). Patients allocated oral corticosteroid, and nasal irrigation demonstrated improved recovery of olfactory function compared with the control group at 40 days (median 60, interquartile range [IQR]: 40 vs. median 30, IQR: 25, = 0.024). Patients allocated to topical corticosteroid nasal spray and olfactory training had improved recovery of olfactory function after 2 weeks (median 7, IQR: 5-10 vs. median 5, IQR: 2-8, = 0.08). Participants allocated to ivabradine had a greater mean reduction in heart rate compared with participants randomized to carvedilol (MD: -4.24, 95% CI: -10.09 to 1.61). Participants allocated to inhaled hydrogen therapy had an improved vital capacity (MD: 0.20, 95% CI: 0.07 to 0.33), forced expiratory volume (MD: 0.19, 95% CI: 0.04 to 0.34), 6-minute walk test (MD: 55.0, 95% CI: 36.04 to 73.96).
The evidence is of low to very low certainty about the effect of all pharmacological interventions investigated for the treatment of people with PCC. There is currently a significant body of research underway that could expand the evidence to inform treatment decisions on pharmacological interventions for PCC.
关于2019冠状病毒病（COVID-19）后状况（PCC）的治疗知之甚少。本文探讨药物干预治疗PCC患者的有效性。
我们检索了Medline、EMBASE、ClinicalTrials.gov和国际临床试验注册平台。两名独立的综述作者筛选文献、提取数据并评估纳入研究的质量。由于参与者、干预措施和结局存在异质性，我们采用叙述性方法综合数据。我们使用GRADE（推荐分级、评估、制定和评价）评估证据的确定性。
PCC患者。
药物干预包括皮质类固醇、伊伐布雷定和吸入氢气。
嗅觉功能、窦性心动过速、呼吸功能。
我们确定了5项完成的研究和41项正在进行的研究。口服皮质类固醇和嗅觉训练在10周后嗅觉评分更高（平均差：5.60，95%置信区间[CI]：1.41至9.79）。在40天时，分配接受口服皮质类固醇和鼻腔冲洗的患者与对照组相比，嗅觉功能恢复情况有所改善（中位数60，四分位间距[IQR]：40 vs.中位数30，IQR：25，P = 0.024）。分配接受局部皮质类固醇鼻喷雾剂和嗅觉训练的患者在2周后嗅觉功能恢复情况有所改善（中位数7，IQR：5 - 10 vs.中位数5，IQR：2 - 8，P = 0.08）。与随机分配接受卡维地洛的参与者相比，分配接受伊伐布雷定的参与者心率平均降低幅度更大（平均差：-4.24，95% CI：-10.09至1.61）。分配接受吸入氢气治疗的参与者肺活量有所改善（平均差：0.20，95% CI：0.07至0.33），用力呼气量（平均差：0.19，95% CI：0.04至0.34），6分钟步行试验（平均差：55.0，95% CI：36.04至73.96）。
对于所研究的所有用于治疗PCC患者的药物干预效果，证据的确定性为低至极低。目前有大量研究正在进行，可能会扩充证据，为PCC药物干预的治疗决策提供依据。
