利巴韦林治疗新型冠状病毒肺炎可能性系统评价

目的系统评价利巴韦林治疗新型冠病毒肺炎的可能性。方法检索PubMed,Embase,The Cochrane Library,以及中国期刊全文数据库(CNKI)、万方数据库(WangFang DATA)、中国生物医学文献数据库(CBM)等有关利巴韦林治疗严重急性呼吸综合征(SARS)和中东呼吸综合征(MERS)的文献,同时回溯纳入文献的参考文献。应用世界卫生组织(WHO)推荐的快速系统评价方法,并对文献质量进行评价,评估利巴韦林治疗2019新型冠状病毒肺炎(COVID-19)的可能性。结果共检索到437篇文章,最终纳入18项研究。SARS疫情期间,我国大陆、香港以及加拿大等国家或地区都有应用高剂量利巴韦林联合干扰素、激素、洛匹那韦/利托那韦(LPV/r)治疗的经验,高剂量利巴韦林的不良反应有贫血、心动过缓、肌痛、低氧血症、电解质紊乱等,这些不良反应可能导致停止药物治疗或不良结局。结论利巴韦林可在联合应用干扰素、激素、LPV/r并严密监测相关不良反应的基础上尝试用于COVID-19的治疗,但其临床有效性还有待更多的随机对照试验来证实。

The Possibility of Ribavirinas in the Treatment of the Coronavirus Disease 2019: A Systematic Review

Objective To systematically review the possibility of ribavirin in the treatment of the coronavirus disease 2019(COVID-19).Methods The relevant literature about ribavirin in the treatment of the severe acute respiratory syndrome(SARS)and the Middle East respiratory syndrome(MERS)was retrieved from PubMed,Embase,The Cochrane Library,CNKI,WangFang DATA,CBM and other databases,and the references included in the literature were retrospectively analyzed.The quality of literature was evaluated by the rapid systematic assessment method recommended by the World Health Organization(WHO),in order to evaluate the possibility of ribavirin in the treatment of the COVID-19.Results Totally 437 articles were retrieved and finally 18 studies were included.The results showed that during the period of the SARS epidemic,China's Mainland,Hong Kong of China,Canada and other regions and countries had the experience of using high-dose ribavirin combined with interferon,hormone,lopinavir/litonavir(LPV/r).The adverse reactions of high-dose ribavirin included anemia,bradycardia,myalgia,hypoxemia,electrolyte disorder and so on,and these adverse reactions might lead to drug discontinuation or adverse outcomes.Conclusion Ribavirin may be used in the treatment of the COVID-19 on the basis of the combination of interferon,hormone,LPV/r and close monitoring of related adverse reactions.However,its clinical efficacy needs more randomized controlled trials to confirm.