治疗新型冠状病毒肺炎药物现有证据的文献分析

目的:对可能用于治疗新型冠状病毒肺炎(corona virus disease-19,COVID-19)的药物的现有证据进行文献检索与分析,为该病的治疗提供循证医学依据。方法:计算机检索PubMed、Clinical Trial.gov和中国临床试验注册中心官方网站,查找有关治疗COVID-19的研究。由2名研究者根据纳入与排除标准独立进行文献筛选,最后按照研究药物类别进行分类总结和分析。结果:有2项个案报道提示,瑞德西韦、洛匹那韦/利托那韦及阿比朵尔可能用于COVID-19的治疗;但1项小样本回顾性队列研究结果提示,洛匹那韦/利托那韦及阿比朵尔的疗效尚不明确;体外研究结果提示,氯喹和达芦那韦具有抗严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)的活性;利巴韦林和干扰素治疗COVID-19的依据主要来源于严重急性呼吸综合征冠状病毒(severe acute respiratory syndrome coronavirus,SARS-CoV)和中东呼吸综合征冠状病毒(Middle East respiratory syndrome coronavirus,MERS-CoV)治疗的间接证据。目前,已有多项评价上述药物治疗COVID-19的疗效及安全性的随机对照试验正在进行中。结论:虽然目前COVID-19的抗病毒治疗方法尚无高质量的循证医学证据支持,但是已有多项评价中医和西医治疗方案临床疗效的研究启动,将为COVID-19的治疗提供高质量的证据支持。

Literature Review of Existing Evidence for Corona Virus Disease-19

OBJECTIVE:To retrieve and analyze the available literature related to treatment for corona virus disease-19(COVID-19),so as to provide reference of evidence-based medicine for future treatment.METHODS:PubMed,Clinical Trial.gov and Chinese Clinical Trial Registry were retrieved to collect available literature related to treatment for COVID-19.Literature were screened by two reviewers independently in accordance with the inclusion and exclusion criteria.Classification and analysis were performed according to the research drug categories.RESULTS:Two case reports suggested that radixivir,lopinavir/ritonavir and abidol may be effective in the treatment of COVID-19;one retrospective cohort study found that the efficacy of arbidol and lopinavir/ritonavir was unclear;in vitro studies suggested that chloroquine and darunavir had anti-virus activity against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2);the evidence of ribavirin and interferon in the treatment of COVID-19 was based primarily on circumstantial evidence of the treatment of severe acute respiratory syndrome coronavirus(SARS-CoV)and Middle East respiratory syndrome coronavirus(MERS-CoV).At present,multiple randomized controlled trials evaluating the efficacy and safety of the above drugs in the treatment of COVID-19 have been conducted.CONCLUSIONS:Although the current antiviral treatment of COVID-19 is not supported by high-quality evidence-based medicine,a number of studies have been launched to evaluate the clinical efficacy of traditional Chinese and western medicine treatment regimens,which will provide high-quality evidence for the treatment of COVID-19.