Re-purposed Anti-viral Agents On Patients' Mortality of COVID-19

重新用途抗病毒藥對COVID-19患者死亡率的影響

蔡崇煌(Chung-Huang Tsai) ； 王任賢(Jen-Hsien Wang) ； 林正介(Cheng-Chieh Lin) ； 黃素雲(Su-Yun Huang) ； 許哲翰(Che-Han Hsu)

《童綜合醫學雜誌》 15卷1期 (2021/06) Pp. 12-15

https://doi.org/10.3966/207135922021061501003

摘要

According to Western media reports, the former U.S. President Donald Trump tested positive for SARS-CoV-2 infection leading to coronavirus disease 2019 (COVID-19); however, after a short period of treatment with a combination of antiviral drugs (antivirals), he then quickly recovered, suggesting great hope internationally for treatment success with the current antivirals. Unfortunately, the interim results of the SOLIDARITY trial by the World Health Organization (WHO) showed that all the promising antivirals had little effect on mortality. The present study reviewed large-scale trials for the current antivirals by using the drug name as the keyword to search published findings. These data were analyzed for 28-day mortality using Comprehensive Meta-Analysis 3.0 software and an integrated forest plot with Microsoft Excel 2019. The results showed that except for the ordinal score 5 (receiving O_2) patients had the benefit result in the Remdesivir trial, there was no significant benefit on mortality for all other antivirals. However, non-antiviral agent Dexamethasone was suggested to use, yet just as adjunctive therapy for more severe patients rather than mild patients.

關鍵字

Dexamethasone ； Remdesivir ； SARS-CoV-2 ； SOLIDARITY ； WHO

並列摘要

根據西方媒體的報導，美國總統川普（Trump，特朗普）對新冠肺炎（SARS-CoV-2，COVID-19）的檢測呈現陽性後，即接受短期混合抗病毒藥物治療，之後很快就康復，因此，世人對當前作為重新用途的抗病毒藥寄予厚望。可惜的是，世界衛生組織（WHO）進行的SOLIDARITY試驗的期中分析結果顯示，所有目前有希望的抗病毒藥物對死亡率幾乎沒影響。我們根據抗病毒藥的名稱作為關鍵詞，選取已發表的大規模試驗，使用Comprehensive Meta-Analysis 3.0分析抗病毒藥對28天死亡率的影響，並使用Microsoft-Excel 2019繪製森林圖。結果在四種藥物的研究結果顯示，除了序數得分為5（接受O2治療）的患者在瑞德西韋（Remdesivir）試驗中具有獲益的結果外，其他目前已發表的所有抗病毒藥物於死亡率均無明顯益處。然而，重症患者建議可使用非抗病毒藥Dexamethasone作為輔助治療，但未使用氧氣的輕症患者不宜。

並列關鍵字

地塞米松 ； 瑞德西韋 ； 新冠肺炎 ； SOLIDARITY ； 世界衛生組織