Umifenovir treatment is not associated with improved outcomes in patients with coronavirus disease 2019: a retrospective study
Umifenovir treatment is not associated with improved outcomes in patients with coronavirus disease 2019: a retrospective study
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DOI：
10.1016/j.cmi.2020.04.026
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发表时间：
2020-07-01
影响因子：
14.2
通讯作者：
Lin, Q.
中科院分区：
文献类型：
--
作者：
Lian, N.;Xie, H.;Lin, Q.
目的：2019冠状病毒病（COVID-19）是由严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）引起的。乌非诺韦（阿比朵尔？）是一种抗病毒药物，在俄罗斯和中国用于治疗流感。本研究旨在研究乌美替诺韦治疗COVID- 19的有效性和安全性。方法：回顾性研究于2020年2月2日至2020年3月20日在金银潭医院非重症监护室（ICU）病房进行。通过咽拭子标本的实时逆转录酶聚合酶链反应（RT-PCR）检测确认COVID-19。将确诊患者按是否使用乌美替诺韦分为乌美替诺韦组和对照组。主要结果是入院后1周内SARS-CoV-2咽拭子检测阴性率和病毒转阴时间。如果连续两次检测SARS-CoV-2核酸均为阴性，则将SARS-CoV-2阴性时间定义为阴性检测的第一天。结果：共纳入81例COVID-19患者，其中乌非诺韦组45例，对照组36例。两组之间的基线临床和实验室特征相当。乌米诺韦组45例患者中有33例（73%）在入院后7天内检测SARS-CoV-2阴性，对照组为28/36例（78%）（p 0.19）。从症状发作到SARS-CoV-2转阴性的中位时间，乌美替诺韦组为18天（四分位距（IQR）12-21），对照组为16天（IQR 11-21）（p 0.42）。乌美替诺韦组患者的住院时间长于对照组患者（13天（IQR 9-17）vs 11天（IQR 9-14），p 0.04）。两组均未发生死亡及严重不良反应。讨论：在非ICU患者中，Umifenovir可能不会改善预后或加速SARS-CoV-2清除。需要一个随机对照临床试验来评估乌美替诺韦的疗效。(c)2020年欧洲临床微生物学和传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Umifenovir (Arbidol ?) is an antiviral drug being used to treat in fluenza in Russia and China. This study aimed to investigate the effectiveness and safety of umifenovir for COVID- 19. Methods: A retrospective study was performed in a non -intensive care unit (ICU) ward in Jinyintan Hospital from 2 February 2020 to 20 March 2020. COVID-19 was con firmed by real-time reverse-tran- scriptase polymerase chain reaction (RT-PCR) assay of pharyngeal swab specimens. The con firmed pa- tients were divided into the umifenovir group and the control group according to the use of umifenovir. The main outcomes were the rate of negative pharyngeal swab tests for SARS-CoV-2 within 1 week after admission and the time for the virus to turn negative. The negativity time of SARS-CoV-2 was de fined as the first day of a negative test if the nucleic acid of SARS-CoV-2 was negative for two consecutive tests. Results: A total of 81 COVID-19 patients were included, with 45 in the umifenovir group and 36 in the control group. Baseline clinical and laboratory characteristics were comparable between the two groups. Thirty-three out of 45 (73%) patients in the umifenovir group tested negative for SARS-CoV-2 within 7 days after admission, the number was 28/36 (78%) in the control group (p 0.19). The median time from onset of symptoms to SARS-CoV-2 turning negative was 18 days (interquartile range (IQR) 12-21) in the umifenovir group and 16 days (IQR 11-21) in the control group (p 0.42). Patients in the umifenovir group had a longer hospital stay than patients in the control group (13 days (IQR 9-17) vs 11 days (IQR 9-14), p 0.04). No deaths or severe adverse reactions were found in both groups. Discussion: Umifenovir might not improve the prognosis or accelerate SARS-CoV-2 clearance in non -ICU patients. A randomized control clinical trial is needed to assess the ef ficacy of umifenovir. (c) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.