利巴韦林治疗严重急性呼吸综合征和中东呼吸综合征的有效性与安全性的系统综述

Systematic Review on Efficacy and Safety of Ribavirin in the Treatment of Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome

目的:基于严重急性呼吸综合征(severe acute respiratory syndrome,SARS)和中东呼吸综合征(Middle East respiratory syndrome,MERS)中利巴韦林的使用进行系统综述,为利巴韦林用于新型冠状病毒肺炎(COVID-19)提供循证医学依据。方法:系统检索PubMed、EMBase等中英文数据库,对所纳入的文献进行质量评价、数据提取,并对疗效、不良反应和用药方案加以分析。结果:经检索共获得3415篇文献,最终纳入77项研究。分析结果显示,利巴韦林治疗SARS、MERS的疗效并未取得一致性结论,且剂量相关的贫血发生率高。结论:根据本文分析,在我国《新型冠状病毒肺炎诊疗方案(试行第七版)》推荐的基础上,建议利巴韦林应在疾病进程早期使用。此外,使用利巴韦林治疗COVID-19的有效性与安全性,仍需在临床应用中进一步研究。

OBJECTIVE:To conduct a systematic review on the application of ribavirin in the treatment of severe acute respiratory syndrome(SARS)and Middle East respiratory syndrome(MERS),so as to provide evidence-based evidence for ribavirin in the treatment of COVID-19.METHODS:Chinese and foreign database including PubMed and EMBase were retrieved,involved studies were conducted quality evaluation and data extraction,efficacy,adverse drug reactions and therapeutic regimen were analyzed.RESULTS:Totally 3415 papers were retrieved,finally 77 studies were enrolled.Analysis results showed that the efficacy of ribavirin in the treatment of SARS and MERS had not reached a consistent conclusion,and the incidence of dose-related anemia was high.CONCLUSIONS:According to the analysis of this article,based on the recommendations of“COVID-19 Diagnosis and Treatment Scheme(Trialed Seventh Edition)”,it is recommended that ribavirin should be used in the early stage of disease progress.In addition,the effectiveness and safety of ribavirin in the treatment of COVID-19 still need further study in clinical applications.