Immune-Based Therapy for Hospitalized Patients With COVID-19 and Risk of Secondary Infections: A Systematic Review and Meta-analysis.
Immune-Based Therapy for Hospitalized Patients With COVID-19 and Risk of Secondary Infections: A Systematic Review and Meta-analysis.
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DOI：
10.1093/ofid/ofac655
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发表时间：
2023-01
影响因子：
4.2
通讯作者：
中科院分区：
文献类型：
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作者：
基于免疫的疗法是需要住院治疗的2019冠状病毒病（COVID-19）患者的标准治疗。然而，与继发性感染的潜在风险相关的安全性问题可能会限制其使用。我们于2020年10月检索了奥维德Medline、奥维德EMBASE、SCOPUS、科克伦图书馆、clinicaltrials.gov和PROSPERO，并于2021年11月更新了检索。我们纳入了随机对照试验（RCT）。成对的评审员筛选摘要和完整的研究，并以独立的方式提取数据。我们使用RevMan进行荟萃分析，使用随机效应模型计算感染发生率的合并风险比（RR）和95%CI。使用I2统计量确定统计异质性。我们评估了所有研究的偏倚风险，并使用建议评估、开发和评价方法分级对证据的确定性进行了评级。我们使用R软件包进行了一项荟萃回归分析，以探讨年龄、性别和有创机械通气是否会改变免疫治疗的感染风险。该方案已在PROSPERO注册（CRD 42021229406）。这是对37项RCT的荟萃分析，包括32621名参与者（平均年龄60岁; 64%为男性）。针对COVID-19使用基于免疫的治疗对继发感染的发生具有轻度保护作用（711/15 721，4.5% vs 616/16 900，3.6%; RR，0.82; 95%CI，0.71-0.95; P = 0.008; I2 = 28%）。亚组分析未发现基于免疫的治疗类型的任何亚组效应（P = .85）。荟萃回归分析显示，年龄、性别或机械通气对基于免疫的治疗对感染风险的影响无影响。我们发现了中等确定性证据，证明在需要住院治疗的COVID-19中使用基于免疫的疗法不会增加继发感染的风险。
Immune-based therapies are standard-of-care treatment for coronavirus disease 2019 (COVID-19) patients requiring hospitalization. However, safety concerns related to the potential risk of secondary infections may limit their use. We searched OVID Medline, Ovid EMBASE, SCOPUS, Cochrane Library, clinicaltrials.gov, and PROSPERO in October 2020 and updated the search in November 2021. We included randomized controlled trials (RCTs). Pairs of reviewers screened abstracts and full studies and extracted data in an independent manner. We used RevMan to conduct a meta-analysis using random-effects models to calculate the pooled risk ratio (RR) and 95% CI for the incidence of infection. Statistical heterogeneity was determined using the I2 statistic. We assessed risk of bias for all studies and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation methodology. We conducted a meta-regression using the R package to meta-explore whether age, sex, and invasive mechanical ventilation modified risk of infection with immune-based therapies. The protocol is registered with PROSPERO (CRD42021229406). This was a meta-analysis of 37 RCTs including 32 621 participants (mean age, 60 years; 64% male). The use of immune-based therapy for COVID-19 conferred mild protection for the occurrence of secondary infections (711/15 721, 4.5%, vs 616/16 900, 3.6%; RR, 0.82; 95% CI, 0.71–0.95; P = .008; I2 = 28%). A subgroup analysis did not identify any subgroup effect by type of immune-based therapies (P = .85). A meta-regression revealed no impact of age, sex, or mechanical ventilation on the effect of immune-based therapies on risk of infection. We identified moderate-certainty evidence that the use of immune-based therapies in COVID-19 requiring hospitalization does not increase the risk of secondary infections.
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影响因子：
120.7
作者：
Caricchio, Roberto;Abbate, Antonio;Noviello, Stephanie
通讯作者：
Noviello, Stephanie
影响因子：
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作者：
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Athalye SN
影响因子：
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作者：
Kyriazopoulou E;Poulakou G;Milionis H;Metallidis S;Adamis G;Tsiakos K;Fragkou A;Rapti A;Damoulari C;Fantoni M;Kalomenidis I;Chrysos G;Angheben A;Kainis I;Alexiou Z;Castelli F;Serino FS;Tsilika M;Bakakos P;Nicastri E;Tzavara V;Kostis E;Dagna L;Koufargyris P;Dimakou K;Savvanis S;Tzatzagou G;Chini M;Cavalli G;Bassetti M;Katrini K;Kotsis V;Tsoukalas G;Selmi C;Bliziotis I;Samarkos M;Doumas M;Ktena S;Masgala A;Papanikolaou I;Kosmidou M;Myrodia DM;Argyraki A;Cardellino CS;Koliakou K;Katsigianni EI;Rapti V;Giannitsioti E;Cingolani A;Micha S;Akinosoglou K;Liatsis-Douvitsas O;Symbardi S;Gatselis N;Mouktaroudi M;Ippolito G;Florou E;Kotsaki A;Netea MG;Eugen-Olsen J;Kyprianou M;Panagopoulos P;Dalekos GN;Giamarellos-Bourboulis EJ
通讯作者：
Giamarellos-Bourboulis EJ
DOI：
10.1016/s2213-2600(21)00099-0
发表时间：
2021-05
期刊：
The Lancet. Respiratory medicine
影响因子：
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作者：
Lescure FX;Honda H;Fowler RA;Lazar JS;Shi G;Wung P;Patel N;Hagino O;Sarilumab COVID-19 Global Study Group
通讯作者：
Sarilumab COVID-19 Global Study Group
DOI：
10.1183/13993003.02808-2020
发表时间：
2020-12
期刊：
The European respiratory journal
影响因子：
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作者：
Edalatifard M;Akhtari M;Salehi M;Naderi Z;Jamshidi A;Mostafaei S;Najafizadeh SR;Farhadi E;Jalili N;Esfahani M;Rahimi B;Kazemzadeh H;Mahmoodi Aliabadi M;Ghazanfari T;Sattarian M;Ebrahimi Louyeh H;Raeeskarami SR;Jamalimoghadamsiahkali S;Khajavirad N;Mahmoudi M;Rostamian A
通讯作者：
Rostamian A