Antiviral agents, glucocorticoids, antibiotics, and intravenous immunoglobulin usage in 1142 patients with coronavirus disease 2019: a systematic review and meta-analysis

作者：Lei Pei, Sheng Zhang, Linxi Huang, Xuqiang Geng, Linhao Ma, Weiwei Jiang, Wenfang Li, Dechang Chen · 发表于：Polskie Archiwum Medycyny Wewnętrznej · 年份：2020 · DOI：10.20452/pamw.15543 · 被引用次数：40 · 研究领域：COVID-19 Clinical Research Studies、SARS-CoV-2 and COVID-19 Research、Long-Term Effects of COVID-19

INTRODUCTION: The treatment effects of antiviral agents, glucocorticoids, antibiotics, and intravenous immunoglobulin are controversial in patients with coronavirus disease 2019 (COVID‑19). OBJECTIVES: This study aimed to evaluate the impact of drug therapy on the risk of death in patients with COVID‑19. PATIENTS AND METHODS: The PubMed, Embase, Web of Science, Cochrane Library, and major preprint platforms were searched to retrieve articles published until April 7, 2020. Subsequently, the effects of specific drug interventions on mortality of patients with COVID‑19 were assessed. Odds ratios (ORs) and relative risks (RRs) with corresponding 95% CIs were pooled using random effects models. RESULTS: Of 3421 references, 6 studies were included. Pooled results from retrospective studies revealed that antiviral agents may contribute to survival benefit (OR, 0.42; 95% CI, 0.17-0.99; P = 0.048; I2 = 82.8%), whereas a single randomized controlled trial found no effects of an antiviral agent on mortality (RR, 0.77; 95% CI, 0.45-1.3; P = 0.33). Glucocorticoid use led to an increased risk of death (OR, 2.43; 95% CI, 1.44-4.1; P = 0.001; I2 = 61.9%). Antibiotics did not significantly affect mortality (OR, 1.13; 95% CI, 0.67-1.89; P = 0.64; I2 = 0%). Similarly, intravenous immunoglobulin had a nonsignificant effect on mortality (OR, 2.66; 95% CI, 0.72-9.89; P = 0.14; I2 = 93.1%). CONCLUSIONS: With the varied heterogeneities across interventions, the current evidence indicated a probable ...