中和抗体治疗非住院新型冠状病毒肺炎患者有效性和安全性的meta分析  

Meta-analysis of the efficacy and safety of neutralizing antibodies in the treatment of non-hospitalized patients with COVID-19

作　　者：冯春露 杨程 刘敏 庹琳 耿晓霞 杨兴祥 FENG Chunlu;YANG Cheng;LIU Min;TUO Lin;GENG Xiaoxia;YANG Xingxiang(Department of Infectious Diseases,Affiliated Hospital of University of Electronic Science and Technology of China/Sichuan Provincial People’s Hospital,Chengdu,Sichuan 610072,China)

机构地区：[1]电子科技大学附属医院·四川省人民医院感染科,成都610072

出　　处：《重庆医学》2023年第15期2345-2350,共6页Chongqing medicine

基　　金：2020四川省卫生健康委员会医学重大创新项目(20ZDCX002)。

摘　　要：目的系统评价中和抗体治疗非住院新型冠状病毒肺炎(COVID-19)患者的有效性和安全性,为轻中度新型冠状病毒肺炎患者的治疗提供参考依据。方法系统检索PubMed、Embase、Wed of science、中国知网(CNKI)、Cochrane Library数据库的随机对照试验。采用RevMan 5.3软件进行meta分析。结果通过文献检索,发现相关文章175篇,初筛后获得16篇文章,最终纳入4个研究,包含5145例患者。3项研究报道了治疗第30天全因病死率,但事件发生率为零,所以排除此项指标;4项研究均报道了治疗第30天住院率或急诊就诊率,结果显示治疗组低于对照组(RR=0.40,95%CI:0.24~0.66,P=0.0004);2项研究报道了治疗第15天病毒转阴率,结果显示治疗组与对照组差异无统计学意义(RR=1.08,95%CI:0.88~1.31,P=0.47);4项研究均报道了不良事件发生率,结果显示治疗组与对照组差异无统计学意义(RR=0.82,95%CI:0.67~1.01,P=0.07)。结论中和抗体的使用可显著降低非住院新型冠状病毒肺炎患者的住院率或急诊就诊率,而在提高病毒转阴率、降低不良事件发生率方面与治疗组差异无统计学意义。Objective To conduct a systematic review on the efficacy and safety of neutralizing antibodies in treating non-hospitalized patients with Corona Virus Disease 2019(COVID-19),and to offer guidance for the treatment of patients with mild to moderate cases of COVID-19.Methods Ran domized controlled trials were systematically searched in PubMed,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),and Cochrane Library databases.meta-analysis was performed using RevMan 5.3 software.Results Through a literature search,175 relevant articles were found.After preliminary screening,16 articles were obtained,and finally,4 studies were included,including 5145 patients.Three studies reported all-cause mortality at day 30 of treatment,but the event rate was zero,so this indicator was excluded.All four studies reported the rate of hospitalization or emergency room visits on the 30th day of treatment.The results indicated that the treatment group had a lower rate compared to the control group(RR=0.40,95%CI:0.24-0.66,P=0.0004).Two studies reported the rate of virus negativity on the 15th day of treatment.The results indicated that there was no statistically significant difference between the treatment group and the control group(RR=1.08,95%CI:0.88-1.31,P=0.47).All four studies reported the incidence of adverse events,and the results showed that there was no significant difference between the treatment group and the control group(RR=0.82,95%CI:0.67-1.01,P=0.07).Conclusion The use of neutralizing antibodies can significantly reduce the hospitalization rate or emergency department visit rate of non-hospitalized patients with COVID-19.However,there is no statistically significant difference between the treatment group and the control group in terms of increasing the virus negative rate and reducing the incidence of adverse events.

关 键 词：中和抗体 新型冠状病毒肺炎 有效性 安全性 META分析 

分 类 号：R512.99[医药卫生—内科学]