莫诺拉韦治疗COVID-19有效性和安全性的Meta分析

Efficacy and safety of Molnupiravir in the treatment of COVID-19:a meta-analysis

目的系统评价莫诺拉韦治疗新型冠状病毒感染(COVID-19)的疗效与安全性。方法计算机检索CNKI、VIP、WanFang Data、PubMed、Web of Science、Cochrane Library和Epistemonikos COVID-19 L OVE数据库,搜集莫诺拉韦治疗COVID-19的随机对照试验(RCT),检索时限均从建库至2023年7月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入9个RCT,包括30675例患者。Meta分析结果显示,两组患者的28~29天住院率、28~29天死亡率、14~15天PCR检测结果转阴率和不良事件发生率的差异均无统计学意义(P>0.05)。莫诺拉韦组显著增加4类系统性器官疾病的不良事件发生率。结论当前证据显示,莫诺拉韦的安全性和对伴有进展为重症高风险COVID-19患者的益处尚不明确。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Objective To systematically review the efficacy and safety of Molnupiravir in the treatment of COVID-19.Methods The CNKI,VIP,WanFang Data,PubMed,Web of Science,Cochrane Library,and Epistemonikos COVID-19 L·OVE databases were electronically searched to collect randomized controlled trials(RCTs)related to Molnupiravir therapy for COVID-19 from inception to July,2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was then performed by using RevMan 5.4 software.Results A total of 9 RCTs involving 32086 patients were included.The meta-analysis results revealed that no significant differences were observed in the 28-29 day hospitalization rate,the 28-29 day mortality rate,14-15 day PCR test conversion rate,or adverse event incidence between the two groups.However,there was a significant increase in adverse events related to four types of systemic organ diseases in the Monolaurin group.Conclusion Current evidence shows that the safety profile of Monolaurin and its potential benefits for COVID-19 patients with a high risk of progressing to severe illness is unclear.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.