新冠肺炎住院患者皮质类固醇类型、地塞米松和甲基强的松龙的比较：系统综述和网络荟萃分析

Global Epidemiology Pub Date : 2023-07-31 DOI:10.1016/j.gloepi.2023.100116

Mina Morsali , Amin Doosti-Irani , Shahideh Amini , Maryam Nazemipour , Mohammad Ali Mansournia , Rasoul Aliannejad

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引用次数: 0

摘要

背景COVID-19与严重肺炎肺损伤、急性呼吸窘迫综合征（ARDS）和死亡率有关。在这项研究中，我们旨在比较皮质类固醇对COVID-19住院患者死亡风险的影响。方法使用预先设计的搜索策略搜索SubMed、Web of Science、Scopus、Cochrane Library和Embase。包括比较皮质类固醇药物的随机对照试验。风险比（HR）和95%置信区间（CI）用于总结网络荟萃分析（NMA）的影响大小。结果在329篇检索到的参考文献中，12项随机对照试验（共11455名参与者）符合本综述的资格标准。纳入的随机对照试验形成了一个包含六种治疗的网络。此外，两个随机对照试验中的五个治疗没有连接到网络。甲基泼尼松+常规护理（UC）与UC相比，死亡风险降低了0.65（95%CI:0.47，0.90）。在网络中的治疗中，最高P分（0.89）与甲基泼尼松龙+UC有关。结论根据该NMA的结果，甲基泼尼龙+UC似乎是新冠肺炎和RDS患者的最佳治疗选择。

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Comparison of corticosteroids types, dexamethasone, and methylprednisolone in patients hospitalized with COVID-19: A systematic review and network meta-analysis

Background

COVID-19 is associated with severe pneumonia lung damage, acute respiratory distress syndrome (ARDS), and mortality. In this study, we aimed to compare corticosteroids' effect on the mortality risk in patients hospitalized with COVID-19.

Methods

PubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched using a predesigned search strategy. Randomized controlled trials (RCTs) that had compared the corticosteroid drugs were included. The hazard ratio (HR) with a 95% confidence interval (CI) was used to summarize the effect size from the network meta-analysis (NMA).

Results

Out of 329 retrieved references, 12 RCTs with 11,455 participants met the eligibility criteria in this review. The included RCTs formed one network with six treatments. In addition, five treatments in two RCTs were not connected to the network. Methylprednisolone + usual care (UC) versus UC decreased the risk of death by 0.65 (95% CI: 0.47, 0.90). Among treatments in the network the highest P-score (0.89) was related to Methylprednisolone + UC.