吸入性皮质类固醇对COVID-19死亡率的影响:随机对照试验的系统审查和元分析
Fen Yang1, Guizuo Wang2, Dong Han2
1Intensive Care Unit, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
概括
吸入性皮质类固醇 (ICS) 并没有显著降低新冠病毒病-2019 (COVID-19) 患者的死亡率或侵入性通风的需要. 这次系统性审查没有发现支持ICS用于改善COVID-19结果的证据.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 新型冠状病毒疾病-2019 (COVID-19) 是一个重大的全球健康问题.
- 吸入性皮质类固醇 (ICS) 通常用于呼吸系统疾病,但它们在COVID-19中的作用尚不清楚.
- 了解ICS对COVID-19死亡率的影响对于临床管理至关重要.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),评估ICS在降低COVID-19患者死亡率方面的有效性.
- 评估ICS对COVID-19相关死亡,所有原因死亡以及侵入性通风的要求的影响.
主要方法:
- 在包括PubMed,Embase,Cochrane图书馆和clinicaltrials.gov.gov在内的主要数据库中进行了全面的系统搜索.
- 包括11项涉及5832名参与者的RCT,这些RCT调查了COVID-19的ICS治疗.
- 数据使用风险比率 (RRs) 和95%置信区间 (CIs) 进行聚合,以比较组间的结果.
主要成果:
- 在ICS治疗患者和对照组之间,在COVID-19相关死亡率 (RR 0.88,95% CI 0.38-2.04) 中没有观察到统计学上显著的差异.
- 同样,对于所有原因的死亡率 (RR 1.05,95% CI 0.49-2.23) 或需要侵入性通风 (RR 1.26,95% CI 0.60-2.62) 也没有发现显著差异.
结论:
- 吸入性皮质类固醇 (ICS) 与诊断为COVID-19的患者的死亡率降低或侵入性通风需求无关.
- 目前来自RCT的证据不支持ICS用于改善COVID-19患者的临床结果.
- 可能需要进一步的研究来探索潜在的特定子组或替代机制,但目前的发现建议不使用常规ICS来获得COVID-19死亡率的好处.
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