Lancet:羟基氯喹/氯喹治疗COVID-19结果公布:降低生存率!

2020-05-23 MedSci原创 MedSci原创

研究人员表示,其无法证实羟氯喹或氯喹单独使用或与大环内酯类药物一起使用时,对COVID-19的院内结局有益处。这些药物治疗COVID-19的方案都与院内生存率下降和心室心律失常的频率增加有关。

目前,尽管没有确凿的证据表明其益处,羟氯喹或氯喹正被广泛用于治疗COVID-19。虽然羟氯喹或氯喹用于自身免疫性疾病或疟疾等批准的适应症时一般是安全的,但对其治疗COVID-19的安全性和效果的评价还较少。

最近,研究人员对使用羟基氯喹或氯喹治疗COVID-19进行了一项多国登记分析。该登记册包括来自六大洲671家医院的数据。研究人员纳入了2019年12月20日到2020年4月14日期间住院的患者,其被实验室证明为SARS-CoV-2阳性。

在诊断后48 h内接受了其中一种治疗的患者被纳入4个治疗组中的一个治疗组(单独使用氯喹、氯喹与大环内酯、单独使用羟氯喹,羟氯喹与大环内酯),没有接受这些治疗的患者组成对照组。

诊断后48 h以上的患者或在接受机械通气治疗的患者,以及接受remdesivir的患者被排除在外。

主要的研究结果是院内死亡率和新发心律失常(非维持性或持续室性心动过速或室颤)的发生率。

在研究期间,96 032名COVID-19患者(平均年龄53-8岁,女性占46-3%)住院治疗,符合纳入标准。其中,14 888名患者被纳入治疗组(1868名患者接受了氯喹,3783名患者接受了氯喹加大环内酯,3016名患者接受了羟氯喹,6221名患者接受了羟氯喹加大环内酯),81 144名患者被纳入对照组。10 698例(11.1%)患者在医院死亡。

在控制多种混杂因素(年龄、性别、种族或民族、体重指数、基础心血管疾病及其危险因素、糖尿病、基础肺部疾病、吸烟、免疫抑制状况、基线疾病严重程度)后,与对照组的死亡率(9.3%)相比,羟氯喹(18.0%。危险比1.335,95%CI 1.223-1.457),羟氯喹与大环内酯(23.8%; 1.447,1.368-1.531),氯喹(16.4%; 1.365,1.218-1.531),和氯喹与大环内酯(22.2%; 1.368,1.273-1.469)各自独立地与院内死亡率的风险增加相关。

与对照组(0.3%)相比,羟氯喹(6.1%;2.369,1.935-2.900)、羟氯喹加大环内酯(8.1%;5.106,4.106-5.983)、氯喹(4.3%;3.561,2.760-4.596)和氯喹加大环内酯(6.5%;4.011,3.344-4.812)与住院期间心室心律失常风险的增加独立相关。

研究人员表示,其无法证实羟氯喹或氯喹单独使用或与大环内酯类药物一起使用时,对COVID-19的院内结局有益处。这些药物治疗COVID-19的方案都与院内生存率下降和心室心律失常的频率增加有关。

 

原始出处:

Prof Mandeep R Mehra et al. Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. The Lancet (2020). DOI: https://doi.org/10.1016/S0140-6736(20)31180-6

 

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    2020-06-23 howi
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    2020-08-27 14818eb4m67暂无昵称

    学习了

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1830654, encodeId=ae9d18306546f, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jun 23 13:27:20 CST 2020, time=2020-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2069774, encodeId=6a082069e743c, content=<a href='/topic/show?id=e2628000e9f' target=_blank style='color:#2F92EE;'>#羟基氯喹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80007, encryptionId=e2628000e9f, topicName=羟基氯喹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Sat Jan 30 20:27:20 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813735, encodeId=6e7f813e35e4, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 08:05:18 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2004418, encodeId=91282004418f4, content=<a href='/topic/show?id=54ebe8621cf' target=_blank style='color:#2F92EE;'>#结果公布#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78621, encryptionId=54ebe8621cf, topicName=结果公布)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Wed May 27 03:27:20 CST 2020, time=2020-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256767, encodeId=23d61256e67a0, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Sun May 24 23:27:20 CST 2020, time=2020-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033796, encodeId=2a851033e96a4, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat May 23 11:27:20 CST 2020, time=2020-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=383066, encodeId=30423830662c, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Sat May 23 09:38:56 CST 2020, time=2020-05-23, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1830654, encodeId=ae9d18306546f, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Jun 23 13:27:20 CST 2020, time=2020-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2069774, encodeId=6a082069e743c, content=<a href='/topic/show?id=e2628000e9f' target=_blank style='color:#2F92EE;'>#羟基氯喹#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80007, encryptionId=e2628000e9f, topicName=羟基氯喹)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Sat Jan 30 20:27:20 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813735, encodeId=6e7f813e35e4, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 08:05:18 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2004418, encodeId=91282004418f4, content=<a href='/topic/show?id=54ebe8621cf' target=_blank style='color:#2F92EE;'>#结果公布#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78621, encryptionId=54ebe8621cf, topicName=结果公布)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Wed May 27 03:27:20 CST 2020, time=2020-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256767, encodeId=23d61256e67a0, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Sun May 24 23:27:20 CST 2020, time=2020-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033796, encodeId=2a851033e96a4, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat May 23 11:27:20 CST 2020, time=2020-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=383066, encodeId=30423830662c, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Sat May 23 09:38:56 CST 2020, time=2020-05-23, status=1, ipAttribution=)]
    2020-05-23 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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    2020-05-23 一天没事干

    很好的学习机会

    0

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