中国药物警戒 ›› 2020, Vol. 17 ›› Issue (7): 393-398.
DOI: 10.19803/j.1672-8629.2020.07.03

• 新型冠状病毒肺炎诊疗药品安全研究专栏 • 上一篇    下一篇

利巴韦林治疗新型冠状病毒肺炎的有效性及安全性的Meta分析

张晋1, 刘子昀1, 张军2, 杨建军3, 张晓钰1, 姜凤丽1, 乌伊萍1, 杨蓓蓓1, 李兴欢1, 陈玉艳1, 刘冬1,*, 任炜4   

  1. 1宝鸡市中心医院临床药学室,陕西 宝鸡 721008;
    2宝鸡市中心医院脊柱外科,陕西 宝鸡 721008;
    3宝鸡市中心医院感染性疾病科,陕西 宝鸡 721008;
    4宝鸡市中心医院,陕西 宝鸡 721008
  • 收稿日期:2020-04-14 修回日期:2020-06-22 出版日期:2020-07-15 发布日期:2020-06-22
  • 通讯作者: *刘冬,女,硕士,主任药师,临床药学。E-mail: liudong691122@126.com
  • 作者简介:张晋,男,硕士,主管药师,临床药学、循证医学。

Meta Analysis of Efficacy and Safety of Ribavirin in the Treatment of COVID-19

ZHANG Jin1, LIU Ziyun1, ZHANG Jun2, YANG Jianjun3, ZHANG Xiaoyu1, JIANG Fengli1, WU Yiping1, YANG Beibei1, LI Xinghuan1, CHEN Yuyan1, LIU Dong1,*, REN Wei4   

  1. 1Clinical Pharmacy Office, Baoji Central Hospital, Baoji Shaanxi 721008, China;
    2Department of Spine Surgery, Baoji Central Hospital, Baoji Shaanxi 721008, China;
    3Department of Infectious Diseases, Baoji Central Hospital, Baoji Shaanxi 721008, China;
    4Baoji Central Hospital, Baoji Shaanxi 721008, China
  • Received:2020-04-14 Revised:2020-06-22 Online:2020-07-15 Published:2020-06-22

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摘要： 目的 通过对既往冠状病毒感染相关临床研究进行系统评价,探索利巴韦林用于新型冠状病毒肺炎临床治疗的可行性。方法 计算机检索Pubmed、EMbase、Cochrane Library、Web of Science、谷歌学术、中国期刊全文数据库(CNKI)、万方数据库(WanFang Data)、维普中文期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)。纳入利巴韦林治疗严重急性呼吸综合征(sever acute respiratory syndrome, SARS)和中东呼吸综合征(middle east respiratory syndrome, MERS)的临床研究,检索时限至2020年4月29日。由2位评价员按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5.3软件进行Meta分析。结果 共纳入7篇文献,总样本量为870例。Meta分析结果显示,在治疗SARS及MERS时,利巴韦林组与对照组间的死亡率无统计学差异[OR=1.10,95％CI（0.79,1.55）,P=0.57]。按照所感染的冠状病毒种类、是否联用干扰素等因素进行亚组分析,发现各组间死亡率同样无统计学差异。研究同时发现,利巴韦林与对照组相比可导致患者的血红蛋白水平降低。结论 利巴韦林治疗SARS及MERS感染时,对于患者的死亡率无显著影响,并可增加用药安全风险,其在治疗新型冠状病毒肺炎时的疗效及安全性仍有待进一步研究。

关键词: 利巴韦林, 新型冠状病毒肺炎, 新型冠状病毒, 严重急性呼吸综合征, 中东呼吸综合征, 系统评价

Abstract: Objective To evaluate the efficacy and safety of ribavirin for COVID-19 by systematically reviewing previous clinical studies of coronavirus pneumonia. Methods Such databases as Pubmed, EMbase, Cochrane Library, Google Scholar, CNKI, Wanfang Data, VIP and CBM were searched. The date of the latest search was April 29, 2020. Clinical studies on ribavirin used in the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) were included. The literature was screened according to the inclusion and exclusion criteria and the methodological quality of the included studies was assessed by two reviewers independently. Meta-analysis was performed using Review Manager 5.3 software. Results In total, 7 studies were included, resulting in a sample size of 870 cases. The overall pooled data demonstrated that the difference in mortality rates between the ribavirin group and control group was not statistically significant in the treatment of SARS and MERS[OR=1.10,95％CI（0.79,1.55）,P=0.57]. In the subgroup analysis, the mortality rate was not significantly different between the ribavirin group and control group in the treatment of SARS and MERS whether ribavirin was combined with interferon or not. Conclusion Ribavirin does not make much difference to mortality in the treatment of SARS and MERS, but it can increase drug safety risks. Thus, the applicability of ribavirin in the treatment of COVID-19 remains to be investigated

Key words: ribavirin, SARS, MERS, COVID-19, SARS, meta-analysis

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