Use of repurposed and adjuvant drugs in hospital patients with covid-19: multinational network cohort study.
Use of repurposed and adjuvant drugs in hospital patients with covid-19: multinational network cohort study.
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在COVID-19患者中使用重新利用和辅助药物：跨国网络队列研究。
DOI：
10.1136/bmj.n1038
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发表时间：
2021-05-11
期刊：
影响因子：
--
通讯作者：
Prieto-Alhambra D
中科院分区：
文献类型：
--
作者：
Prats-Uribe A;Sena AG;Lai LYH;Ahmed WU;Alghoul H;Alser O;Alshammari TM;Areia C;Carter W;Casajust P;Dawoud D;Golozar A;Jonnagaddala J;Mehta PP;Gong M;Morales DR;Nyberg F;Posada JD;Recalde M;Roel E;Shah K;Shah NH;Schilling LM;Subbian V;Vizcaya D;Zhang L;Zhang Y;Zhu H;Liu L;Cho J;Lynch KE;Matheny ME;You SC;Rijnbeek PR;Hripcsak G;Lane JC;Burn E;Reich C;Suchard MA;Duarte-Salles T;Kostka K;Ryan PB;Prieto-Alhambra D
调查三大洲因新冠肺炎入院的患者中重新使用和辅助药物的情况。多国网络队列研究。来自美国、西班牙和中国的医院电子健康记录，以及来自韩国的全国索赔数据。2020年1月至2020年12月，303 264名新冠肺炎患者入院治疗。在因新冠肺炎入院当日或入院后30天内开具的任何药物处方或配药。在纳入的303264例患者中，290131例来自美国，7599例来自韩国，5230例来自西班牙，304例来自中国。共鉴定出3455种药物。常见的再利用药物是羟氯喹（中国患者<5例（<2%）至2165例（西班牙为85.1%），阿奇霉素（从中国的15个（4.9%）到1473个（西班牙为57.9%），洛匹那韦和利托那韦联合用药（从VA-OMOP US的156例（<2%）到韩国的2，652例（34.9%）和西班牙的1285例（50.5%）），以及umifenovir（美国、韩国和西班牙为0%，中国为238例（78.3%））。抗感染药物的使用差异很大，5种最常用的治疗药物是依诺肝素、氟喹诺酮类、头孢曲松、维生素D和皮质类固醇。2020年3月至4月，羟氯喹的使用量迅速增加，但在5月至6月急剧下降，并在今年剩余时间保持低位。地塞米松及皮质类固醇的使用于二零二零年稳步增加。新型冠状病毒肺炎（COVID-19，即2019冠状病毒病）大流行的头几个月使用了多种药物，在地域和时间上存在很大差异。羟氯喹、阿奇霉素、洛匹那韦-利托那韦和乌非诺韦（仅在中国）是处方中最常被转用的药物。抗血栓药、抗生素、H2受体拮抗剂和皮质类固醇常被用作预防性治疗。需要对这些治疗在新冠肺炎管理中的相对风险和获益进行研究。
To investigate the use of repurposed and adjuvant drugs in patients admitted to hospital with covid-19 across three continents. Multinational network cohort study. Hospital electronic health records from the United States, Spain, and China, and nationwide claims data from South Korea. 303 264 patients admitted to hospital with covid-19 from January 2020 to December 2020. Prescriptions or dispensations of any drug on or 30 days after the date of hospital admission for covid-19. Of the 303 264 patients included, 290 131 were from the US, 7599 from South Korea, 5230 from Spain, and 304 from China. 3455 drugs were identified. Common repurposed drugs were hydroxychloroquine (used in from <5 (<2%) patients in China to 2165 (85.1%) in Spain), azithromycin (from 15 (4.9%) in China to 1473 (57.9%) in Spain), combined lopinavir and ritonavir (from 156 (<2%) in the VA-OMOP US to 2,652 (34.9%) in South Korea and 1285 (50.5%) in Spain), and umifenovir (0% in the US, South Korea, and Spain and 238 (78.3%) in China). Use of adjunctive drugs varied greatly, with the five most used treatments being enoxaparin, fluoroquinolones, ceftriaxone, vitamin D, and corticosteroids. Hydroxychloroquine use increased rapidly from March to April 2020 but declined steeply in May to June and remained low for the rest of the year. The use of dexamethasone and corticosteroids increased steadily during 2020. Multiple drugs were used in the first few months of the covid-19 pandemic, with substantial geographical and temporal variation. Hydroxychloroquine, azithromycin, lopinavir-ritonavir, and umifenovir (in China only) were the most prescribed repurposed drugs. Antithrombotics, antibiotics, H2 receptor antagonists, and corticosteroids were often used as adjunctive treatments. Research is needed on the comparative risk and benefit of these treatments in the management of covid-19.
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DOI：
10.15557/pimr.2020.0003
发表时间：
2020-01-01
影响因子：
3.6
作者：
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DOI：
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发表时间：
2021-01-01
影响因子：
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作者：
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影响因子：
4
作者：
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DOI：
10.1016/j.ijantimicag.2020.105949
发表时间：
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影响因子：
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影响因子：
120.7
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