黏液溶解性祛痰药辅助治疗新型冠状病毒肺炎重症患者的回顾性分析

Clinical Efficacy of Mucinous Lytic Expectorants in Adjuvant Treatment of Patients Hospitalized with Severe Coronavirus Disease 2019:A Retrospective Study

目的探讨黏液溶解性祛痰药治疗新型冠状病毒肺炎(COVID-19)重症患者的临床疗效。方法对2020年2月1日—3月10日收治于华中科技大学同济医学院附属协和医院西院治疗的COVID-19重症患者进行回顾性分析。按实际治疗方案分为黏液溶解性祛痰药治疗组和对照组,主要研究终点为依据7分等级量表评估的临床好转时间,次要研究终点为死亡率和核酸转阴时间。结果共纳入COVID-19重症患者208例,其中黏液溶解性祛痰药治疗组127例,对照组81例。两组在人口学特征、临床症状及实验室检查均无显著差异,入院第1天的临床情况亦无统计学差异,具有良好的可比性。黏液溶解性祛痰药不能明显缩短患者临床好转时间(P=0.129)或提高累计临床改善率(P=0.756,HR=0.949,95%CI 0.683-1.318),对核酸转阴时间和死亡率亦无改善作用。结论黏液溶解性祛痰药治疗对COVID-19重症患者作用不明显。

Objective To explore the clinical efficacy of mucinous lytic expectorants in patients hospitalized with severe COVID-19.Methods Severe COVID-19 patients who were hospitalized in Wuhan Union West Campus between February 1,2020 and March 10,2020 were enrolled in the retrospective study.Patients were divided into two groups based on the use of mucinous lytic expectorants.The primary endpoint was the clinical improvement time assessed on a seven-category ordinal scale.The secondary endpoints included mortality and time to negative conversion using throat swab SARS-CoV-2 nucleic acid test.Results Total 127 patients were treated with mucinous lytic expectorants while 81 were not.There were no significant differences between two group in demographic characteristics,laboratory test results,and distribution of ordinal scale scores at enrollment.Treatment with mucinous lytic expectorants was not associated with a difference in the time to clinical improvement(P=0.129)and the accumulative rate of clinical improvement(P=0.7557,HR=0.949,95%CI=0.683-1.318).There were also no significant differences in the time to throat swab SAR-CoV-2 nucleic acid negative conversion and mortality.Conclusion In hospitalized adult patients with severe COVID-19,no significant benefit was observed with mucinous lytic expectorants treatment.