托西利祖马布在COVID-19肺炎患者中的有效性:系统性审查
Johanah Laisah M Salo1, Lyka Jam N Marcelo1, Ariana Claire A Sanchez1
1College of Pharmacy, Adamson University, Manila, Philippines.
Acta medica Philippina
|February 19, 2025
概括
在老年COVID-19肺炎患者中使用托西利祖马布 (TCZ) 显示出混合的死亡率结果,但减少了机械通风需求和住院时间. 由于与TCZ治疗的潜在联系,对二次感染的密切监测至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 老年医学 老年医学
背景情况:
- COVID-19显著影响全球健康,老年人和患有并发症的人面临更高的风险.
- 托西利祖马布 (TCZ) 是一种用于管理严重的COVID-19症状的药物,但其对老年患者的疗效仍然不确定.
- 本综述专门评估TCZ在50岁及以上人群中治疗严重肺炎的有效性.
研究的目的:
- 评估托西利祖马布 (TCZ) 在50岁及以上患者中治疗严重COVID-19肺炎的疗效.
- 综合目前关于TCZ对死亡率,机械通风和住院时间的影响的证据.
- 为了确定与老年COVID-19患者TCZ使用相关的潜在风险,例如二次感染.
主要方法:
- 在多个数据库 (如PubMed,Web of Science) 和灰色文献中进行系统的文献搜索.
- 包括在2020年至2022年期间发表的英语原始研究文章,涵盖各种研究设计.
- 证据的叙述综合,使用NIH工具和GRADE进行质量评估,以确保证据的确定性.
主要成果:
- 五项研究符合标准,显示TCZ对死亡率的影响有所不同 (29%与控制组在输管后30天内的40%相比).
- 虽然TCZ与降低死亡率没有明确联系,但与更短的住院时间和更少的机械通风需求有关.
- 在TCZ组中观察到呼吸机相关肺炎的更高率 (45%对20%),60岁以上的年龄被确定为显著的风险因素.
结论:
- 关于TCZ对严重COVID-19肺炎死亡率的影响的证据仍然没有确定性.
- 似乎TCZ的使用缩短了住院时间,减少了机械通风的需求,并降低了ICU转移的可能性.
- 由于TCZ有可能增加二次感染,因此需要仔细监测患者是否有不良影响.
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