药物干预对COVID-19后疾病患者的治疗效果:快速回顾

K. M. Saif-Ur-Rahman, Kavita Kothari, Corinna Sadlier, Frank Moriarty, Ani Movsisyan, Sean Whelan, Petek E. Taneri, Matthew Blair, Gordon Guyatt, Declan Devane
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引用次数: 2

摘要

目的对2019年新冠肺炎后冠状病毒病(PCC)的治疗方法知之甚少。本文探讨了药物干预治疗PCC患者的有效性。方法检索Medline、EMBASE、ClinicalTrials。gov和国际临床试验注册平台。两位独立综述作者筛选引文,提取数据,并评估纳入研究的质量。由于参与者、干预措施和结果的异质性,我们对数据进行了叙述性综合。我们使用GRADE(建议、评估、发展和评估的分级)来评估证据的确定性。参与者PCC患者。干预措施药理学干预措施包括皮质类固醇、伊伐布雷定和吸入氢气。结果测量嗅觉功能、窦性心动过速、呼吸功能。结果我们确定了5项已完成的研究和41项正在进行的研究。口服皮质类固醇和嗅觉训练在10周后嗅觉得分更高(MD:5.60,95%置信区间[CI]:1.41-9.79)。与对照组相比,患者在40天时分配口服皮质类固醇,鼻腔冲洗显示嗅觉功能恢复改善(中位数60,四分位间距[IQR]:40 vs.中位数30,IQR:25,p = 0.024)。接受局部皮质类固醇鼻喷雾剂和嗅觉训练的患者在2周后嗅觉功能的恢复有所改善(中位数7,IQR:5−10 vs.中位数5,IQR:2−8,p = 0.08)。与随机分配给卡维地洛的参与者相比,分配给伊伐布雷定的参与者平均心率下降幅度更大(MD:-4.24,95%CI:-10.09至1.61)。分配给吸入氢疗法的参与者肺活量(MD:0.20,95%CI:0.07至0.33)、用力呼气量(MD:0.19,95%CI:0.04至0.34)、,6分钟步行试验(MD:55.0,95%CI:36.04-73.96)。目前有一项重要的研究正在进行中,可以扩大证据,为PCC药物干预的治疗决策提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Effect of pharmacological interventions for the treatment of people with post-COVID-19 condition: A rapid review

Effect of pharmacological interventions for the treatment of people with post-COVID-19 condition: A rapid review

Objective

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.

Methods

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).

Participants

People with PCC.

Interventions

Pharmacological interventions include corticosteroids, ivabradine, and inhaled hydrogen.

Outcome Measures

Olfactory function, sinus tachycardia, respiratory function.

Results

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, p = 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, p = 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).

Conclusions

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.

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