系统性皮质类固醇和COVID-19重症患者死亡率之间的关联:一项元分析
, Jonathan A C Sterne1,2, Srinivas Murthy3
1Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England.
在需要呼吸支持的住院COVID-19患者中,皮质类固醇显著降低了死亡率. 与常规治疗相比,这项元分析证实了它们降低28天全因死亡率的有效性.
科学领域:
- 危急护理医学
- 传染性疾病
- 药理学
背景情况:
- 2019年新冠病毒病 (COVID-19) 构成了全球重大健康威胁,需要有效的治疗干预措施.
- 住院患者,尤其是需要呼吸辅助的患者,面临高死亡风险.
研究的目的:
- 评估皮质类固醇给药与严重病情的COVID-19患者28天全因死亡率之间的关联.
- 将皮质类固醇与常规治疗或安慰剂在降低COVID-19死亡率方面的疗效进行比较.
主要方法:
- 一项前性元分析,汇集了涉及1703名重症COVID-19患者的7项随机临床试验的数据.
- 使用逆方差加权的固定效应和随机效应的元分析来量化皮质类固醇使用与死亡率之间的关联.
主要成果:
- 皮质类固醇的使用与28天全因死亡率的显著降低有关 (固定效果OR,0. 64;P<. 001).
- 在此分析中,德克萨米他显示出显著的死亡益处 (OR,0. 64;P < . 001),而水皮质和甲基普雷尼索隆则没有达到统计学意义.
- 报告了严重的不良反应,但主要关注的是降低死亡率.
结论:
- 系统性皮质类固醇与重症COVID-19患者的28天全因死亡率较低有关.
- 这些发现支持使用皮质类固醇作为有效的治疗方法来减少这种患者群体的死亡率.
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