75岁以上老年新型冠状病毒肺炎患者应用阿兹夫定安全性研究

目的 探讨阿兹夫定治疗75岁以上新型冠状病毒肺炎（COVID-19）的安全性。方法 通过医院电子病例系统收集2022年12月—2023年2月南京医科大学附属老年医院应用阿兹夫定治疗的≥75岁COVID-19患者病例资料，对阿兹夫定的不良反应发生情况（不良反应名称、发生时间、临床表现、严重程度、关联性评价等）以及转归等进行回顾性分析。结果 纳入74例患者发生不良反应的有28例（37.8%）。28例患者中，消化系统症状者20例（主要表现为肝功能异常10例、腹泻7例、恶心呕吐2例、淀粉酶升高1例），血液系统不良反应6例（血小板升高），泌尿系统（肌酐升高）3例，心血管系统症状（心动过速）2例，电解质紊乱1例；其中2例患者同时出现2个系统症状，分别为消化系统合并血液系统和消化系统合并心血管系统以及2例患者发生消化系统2个症状。发生1级不良反应26例（92.8%），2级1例（3.6%），严重不良反应患者1例（3.6%）。其中2例患者因不良反应停药，1例为不能耐受恶心呕吐停药，1例为严重肝功能损伤停药。结论 阿兹夫定治疗75岁以上老年COVID-19患者安全性较好，主要表现为轻微的消化系统症状，以肝功能异常、腹泻较为多见。

Adverse reaction of Azvudine in elderly patients with COVID-19 over 75 years old

Objective To explore the safety of Azvudine in the treatment of patients with coronavirus disease 2019 (COVID-19) over 75 years. Methods Medical records of patients with COVID-19 over 75 years who were hospitalized in Geriatric Hospital of Nanjing Medical University and treated with Azvudine from December 2022 to February 2023 were collected through the hospital electronic medical record system. The occurrence (name, time of occurrence, clinical manifestations, severity, etc.) and outcomes of adverse reactions were analyzed retrospectively. Results Adverse reactions occurred in 28 of 74 patients (37.8%). Among the 28 patients, 20 cases had digestive system symptoms (mainly manifested as abnormal liver function in 10 cases, diarrhea in seven cases, nausea and vomiting in two cases, amylase increase in one case), six cases had blood system symptoms (thrombocytosis), three cases had urinary system symptoms (creatinine elevation), two cases had cardiovascular system symptoms (tachycardia), one case had electrolyte disturbance (potassium reduction). Of them, two patients had two systemic symptoms at the same time, namely digestive system combined with blood system and digestive system combined with cardiovascular system, and two patients had two symptoms of digestive system. The severity of adverse reactions was grade one in 26 patients (92.8%), grade two in one patient (3.6%), and serious adverse reaction of grade five in one patient(3.6%). Two patients discontinued the drug because of intolerance to nausea and vomiting and severe liver injury respectively. Conclusion Azvudine has a good safety in the treatment of over 75 years with COVID-19. The adverse reaction is mild digestive system symptoms, mainly abnormal liver function and diarrhea.