Eur Respir J:轻度Covid-19患者早期使用硝唑尼特的疗效分析

2021-01-17 MedSci原创 MedSci原创

在轻度Covid-19患者中,在治疗5天后,硝唑尼特组和安慰剂组的症状缓解没有差异。但是,早期的硝唑尼特治疗是安全的,并且可以显著降低病毒载量。

硝唑尼特在临床上广泛使用,并在体外具有广谱抗病毒活性。但是,尚无证据表明其对SARS-CoV-2感染有疗效。

近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,这项多中心、随机、双盲、安慰剂对照试验纳入了Covid-19症状(干咳、发烧和/或疲劳)出现3天内就诊的成年患者。研究人员通过鼻咽拭子样本RT-PCR确认SARS-CoV2感染,并将患者按1:1的比例随机分配接受硝唑尼特(500 mg)或安慰剂治疗5天。该研究的主要结局是症状完全缓解,次要结局是病毒载量、实验室检查结果、血清炎症生物标志物和住院率。研究人员还评估了不良事件。

从2020年6月8日至8月20日,研究人员共筛选了1575例患者,最终分析了392名受试者(安慰剂组198人,硝唑尼特组194人)。从症状发作到首次服用研究药物的中位时间为5(4-5)天。在为期5天的研究随访期间,硝唑尼特和安慰剂组受试者的症状缓解没有差异。硝唑尼特组29.9%患者的拭子SARS-CoV-2阴性,而安慰剂组为18.2%(p=0.009)。与安慰剂相比,硝唑尼特治疗后病毒载量也显著降低(p=0.006)。从治疗开始到治疗结束硝唑尼特(55%)组的病毒载量减少百分比大于安慰剂组(45%)(p=0.013)。其它次要结局无明显差异。没有观察到严重的不良事件。

由此可见,在轻度Covid-19患者中,在治疗5天后,硝唑尼特组和安慰剂组的症状缓解没有差异。但是,早期的硝唑尼特治疗是安全的,并且可以显著降低病毒载量。

原始出处:

Patricia R. M. Rocco,et al.Early use of nitazoxanide in mild Covid-19 disease: randomised, placebo-controlled trial.Eur Respir J.2021.https://erj.ersjournals.com/content/early/2021/01/04/13993003.03725-2020

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1647291, encodeId=660d164e29160, content=<a href='/topic/show?id=e9bae04003f' target=_blank style='color:#2F92EE;'>#疗效分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70400, encryptionId=e9bae04003f, topicName=疗效分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=219323401160, createdName=rebeccajiejie, createdTime=Wed Apr 21 19:42:02 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918714, encodeId=fe81918e1459, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a8b95453181, createdName=ms2000001615968410, createdTime=Thu Jan 21 16:03:54 CST 2021, time=2021-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918121, encodeId=b351918121aa, content=有效吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210117/81abe17ec07a4063a72fbd0fff64281a/9f8d6f1cf05945a390bbdb9a0c424ae1.jpg, createdBy=544d5450954, createdName=ms4000000988700136, createdTime=Tue Jan 19 17:38:34 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297508, encodeId=45ce129e50857, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Tue Jan 19 05:42:02 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032763, encodeId=917d1032e63f8, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sun Jan 17 17:42:02 CST 2021, time=2021-01-17, status=1, ipAttribution=)]
    2021-01-21 ms2000001615968410

    厉害

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1647291, encodeId=660d164e29160, content=<a href='/topic/show?id=e9bae04003f' target=_blank style='color:#2F92EE;'>#疗效分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70400, encryptionId=e9bae04003f, topicName=疗效分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=219323401160, createdName=rebeccajiejie, createdTime=Wed Apr 21 19:42:02 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918714, encodeId=fe81918e1459, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a8b95453181, createdName=ms2000001615968410, createdTime=Thu Jan 21 16:03:54 CST 2021, time=2021-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918121, encodeId=b351918121aa, content=有效吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210117/81abe17ec07a4063a72fbd0fff64281a/9f8d6f1cf05945a390bbdb9a0c424ae1.jpg, createdBy=544d5450954, createdName=ms4000000988700136, createdTime=Tue Jan 19 17:38:34 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297508, encodeId=45ce129e50857, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Tue Jan 19 05:42:02 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032763, encodeId=917d1032e63f8, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sun Jan 17 17:42:02 CST 2021, time=2021-01-17, status=1, ipAttribution=)]
    2021-01-19 ms4000000988700136

    有效吗?

    0

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    2021-01-17 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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