COVID-19患者抗凝剂剂量死亡率和出血风险的比较:系统回顾和荟萃分析

IF 0.7 Q4 PHARMACOLOGY & PHARMACY INDONESIAN JOURNAL OF PHARMACY Pub Date : 2022-04-22 DOI:10.22146/ijp.2697
A. F. Purnomo, M. Syaban, I. Faratisha, Firstya Diyah Ekasiwi, M. Juwono, Nur Hudayana, Edwin Kinesya, Yusuf Mannagalli, E. Pasaribu
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引用次数: 2

摘要

抗凝治疗对于预防COVID-19患者高凝状态引起的进一步并发症至关重要。抗凝剂的最佳剂量和时间依赖性仍然是未知的。本研究的目的是确定COVID-19患者使用抗凝剂的死亡率和出血风险。我们收集了一些文章的数据,这些文章比较了2020年至2021年左右发表的研究中在线记录的COVID-19患者的预防性和治疗性抗凝剂。我们根据纳入标准从科学数据库(如ScienceDirect、Cochrane、ProQuest、PubMed和Google Scholar)中选取文章。数据分析采用Review Manager Version 5.4.1 (Cochrane, Copenhagen, Denmark),分类数据采用Mantel-Haenzel统计方法测量相对风险(Relative Risk, RR)和95%置信区间(95% Confidence Interval, CI)。如果P为异质性(pHet <0.1),我们使用随机效应分析模型;如果pHet≥0.1,我们使用固定效应分析模型。基于时间依赖性,抗凝治疗对降低死亡率没有益处(RR = 0.69;95% CI = 0.47 ~ 1.02)。此外,基于剂量依赖性,预防性抗凝剂有利于预防死亡(RR = 0.49;CI 95%;P = 0.02)。治疗性抗凝剂也显示出较高的出血风险(RR = 0.27;CI 95%;P < 0.000001)。治疗性剂量在降低死亡率方面没有明显优于预防性剂量。治疗性抗凝剂在COVID-19患者中出血的风险更高。由于副作用比治疗剂量少,建议使用预防剂量。
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Comparison of the Mortality and Bleeding Risk of Anticoagulant Doses in COVID-19 Patients: A Systematic Review and Meta-analysis
Anticoagulant therapy becomes critical to preventing further complications caused by the hypercoagulative state in COVID-19 patients. The optimal dose and time-dependent administration of anticoagulants remains unknown. The purpose of this study was to determine the mortality and bleeding risks of anticoagulants administered to COVID-19 patients. We collected data from articles that compared prophylactic and therapeutic anticoagulants in COVID-19 patients recorded online from studies that were published around 2020 to 2021. We were taking the articles from a scientific database such as ScienceDirect, Cochrane, ProQuest, PubMed, and Google Scholar based on the inclusion criteria. Data analysis was conducted using Review Manager Version 5.4.1 (Cochrane, Copenhagen, Denmark) using Mantel-Haenzel statistical method for categorical data to measure Relative Risk (RR) and 95% Confidence Interval (CI). We use a random-effect analysis model if P for heterogeneity (pHet <0.1) and a fixed-effect analysis model if pHet ≥0.1. Based on time dependent-manner, therapeutic anticoagulant showed no benefit in reducing mortality (RR = 0.69; 95% CI = 0.47 to 1.02). Beside, based on dose-dependent manner, prophylactic anticoagulant was found beneficial to prevent mortality (RR = 0.49; CI 95%; p = 0.02) compared to therapeutic. Therapeutic anticoagulants also showed higher risk of bleeding (RR = 0.27; CI 95%; p < 0.000001) compared to prophylactic. Therapeutic have no significantly benefit over prophylactic dose in reducing mortality rates. Therapeutic anticoagulant has a higher risk of bleeding in patients with COVID-19. Administer prophylactic dose is recommended due to the fewer side effects compared to the therapeutic dose.
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来源期刊
INDONESIAN JOURNAL OF PHARMACY
INDONESIAN JOURNAL OF PHARMACY PHARMACOLOGY & PHARMACY-
CiteScore
1.20
自引率
0.00%
发文量
38
审稿时长
12 weeks
期刊介绍: The journal had been established in 1972, and online publication was begun in 2008. Since 2012, the journal has been published in English by Faculty of Pharmacy Universitas Gadjah Mada (UGM) Yogyakarta Indonesia in collaboration with IAI (Ikatan Apoteker Indonesia or Indonesian Pharmacist Association) and only receives manuscripts in English. Indonesian Journal of Pharmacy is Accredited by Directorate General of Higher Education. The journal includes various fields of pharmaceuticals sciences such as: -Pharmacology and Toxicology -Pharmacokinetics -Community and Clinical Pharmacy -Pharmaceutical Chemistry -Pharmaceutical Biology -Pharmaceutics -Pharmaceutical Technology -Biopharmaceutics -Pharmaceutical Microbiology and Biotechnology -Alternative medicines.
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