伊马替尼对 COVID-19 住院患者的短期和长期影响：随机试验

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2024-07-03 DOI:10.1016/j.jinf.2024.106217

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引用次数: 0

摘要

目的：我们研究了伊马替尼对住院COVID-19患者的短期和长期影响：我们研究了伊马替尼对COVID-19住院患者的短期和长期影响：参与者被随机分配接受标准护理（SoC）或含有伊马替尼的SoC。伊马替尼剂量为每天400毫克，直至出院（最长14天）。主要结果为30天和1年的死亡率。次要结果包括恢复情况、生活质量和 1 年后的长期 COVID 症状。我们还对伊马替尼治疗住院 COVID-19 患者 30 天死亡率的随机试验进行了系统回顾和荟萃分析：我们对 156 名患者进行了随机治疗（73 人接受了 SoC 治疗，83 人接受了伊马替尼治疗）。在服用伊马替尼的患者中，7.2%的患者在30天内死亡，13.3%的患者在1年内死亡，而在SoC中，4.1%的患者在30天内死亡，8.2%的患者在1年内死亡（调整后HR为1.35，95% CI为0.47-3.90）。1年后，伊马替尼患者中79.0%的人自我报告痊愈，SoC患者中88.5%的人自我报告痊愈（RR 0.91，0.78-1.06）。在生活质量或症状方面，我们没有发现令人信服的差异。一年后，疲劳（24%）和睡眠问题（20%）经常困扰患者。在荟萃分析中，伊马替尼的死亡率风险比为0.73（0.32-1.63；低确定性证据）：有证据表明，伊马替尼在降低COVID-19住院患者的死亡率、改善康复和预防长期COVID症状方面的益处值得怀疑。

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Short- and long-term effects of imatinib in hospitalized COVID-19 patients: A randomized trial

Objectives

We studied the short- and long-term effects of imatinib in hospitalized COVID-19 patients.

Methods

Participants were randomized to receive standard of care (SoC) or SoC with imatinib. Imatinib dosage was 400 mg daily until discharge (max 14 days). Primary outcomes were mortality at 30 days and 1 year. Secondary outcomes included recovery, quality of life and long COVID symptoms at 1 year. We also performed a systematic review and meta-analysis of randomized trials studying imatinib for 30-day mortality in hospitalized COVID-19 patients.

Results

We randomized 156 patients (73 in SoC and 83 in imatinib). Among patients on imatinib, 7.2% had died at 30 days and 13.3% at 1 year, and in SoC, 4.1% and 8.2% (adjusted HR 1.35, 95% CI 0.47–3.90). At 1 year, self-reported recovery occurred in 79.0% in imatinib and in 88.5% in SoC (RR 0.91, 0.78–1.06). We found no convincing difference in quality of life or symptoms. Fatigue (24%) and sleep issues (20%) frequently bothered patients at one year. In the meta-analysis, imatinib was associated with a mortality risk ratio of 0.73 (0.32–1.63; low certainty evidence).

Conclusions

The evidence raises doubts regarding benefit of imatinib in reducing mortality, improving recovery and preventing long COVID symptoms in hospitalized COVID-19 patients.

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.