Impact of some antiviral drugs on health care utilization for patients with COVID-19: a systematic review and meta-analysis.

IF 4.2 2区医学 Q1 INFECTIOUS DISEASES Expert Review of Anti-infective Therapy Pub Date : 2023-09-05 DOI:10.1080/14787210.2023.2254491

Bincai Wei, Ruhao Zhang, Huatang Zeng, Liqun Wu, Rongxin He, Junyao Zheng, Hao Xue, Jinlin Liu, Fengchao Liang, Bin Zhu

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Abstract

Background: We aimed to assess the impact of antiviral drugs (fluvoxamine,remdesivir, lopinavir/ritonavir (LPV/r), molnupiravir, andnirmatrelvir/ritonavir (NRV/r)) on health care utilization (HCU) inCOVID-19 patients. We summarized findings from randomized controlledtrials (RCTs) and observational studies.

Methods: We systematically searched four medical databases (PubMed, Web of Science, Embase, Cochrane Library) for COVID-19 studies up to February 15, 2023. A comprehensive review, meta-analysis, sensitivity analysis, and subgroup analysis were conducted. Pooled effects with 95% confidence intervals (CIs) were calculated for antiviral drugs' impact on hospitalization, mechanical ventilation (MV), and intensive care unit (ICU) outcomes.

Results: Our analysis included 34 studies (584,978 patients). Meta-analysisindicated potential benefits: remdesivir and molnupiravir potentiallyreduced MV risk, and NRV/r correlated with lower hospitalizationrates. However, LPV/r did not notably curb HCU. Remdesivir waspreferable for high-risk COVID-19 patients, while molnupiravir andNRV/r were recommended for those aged 60 and above.

Conclusion: Remdesivir, molnupiravir, and NRV/r may reduce HCU during the COVID-19 pandemic. However, due to limited study details and significant heterogeneity in effect estimates, further precise evidence is crucial, especially concerning emerging variants.

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部分抗病毒药物对COVID-19患者医疗保健利用的影响:系统综述和荟萃分析

背景:我们旨在评估抗病毒药物(氟伏沙明、瑞德西韦、洛匹那韦/利托那韦(LPV/r)、莫努匹拉韦和尼马特利韦/利托那韦(NRV/r))对covid -19患者医疗保健利用(HCU)的影响。我们总结了随机对照试验(rct)和观察性研究的结果。方法:系统检索截至2023年2月15日的4个医学数据库(PubMed、Web of Science、Embase、Cochrane Library)，检索COVID-19研究。进行综合评价、荟萃分析、敏感性分析和亚组分析。以95%置信区间(ci)计算抗病毒药物对住院、机械通气(MV)和重症监护病房(ICU)结局的综合效应。结果:我们的分析包括34项研究(584,978例患者)。荟萃分析显示了潜在的益处:remdesivir和molnupiravir可能降低MV风险，NRV/r与较低的住院率相关。然而，LPV/r并没有显著抑制HCU。高危COVID-19患者优先使用Remdesivir, 60岁及以上患者推荐使用molnupiravir和nrv /r。结论:Remdesivir、molnupiravir和NRV/r可降低COVID-19大流行期间的HCU。然而，由于有限的研究细节和效果估计的显著异质性，进一步的精确证据是至关重要的，特别是关于新出现的变异。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.