| 摘要: |
| 目的：采用循证评价和文献综述的方法，总结和分析目前已发表的儿童SARS-CoV-2感染病例、临床实践指南或专家共识以及儿童SARS/MERS感染药物治疗经验，以期为儿童SARS-CoV-2感染药物治疗方案的制定提供循证依据。方法：系统检索PubMed、Embase、the Cochrane Library、CNKI（含新型冠状病毒肺炎专题知识库）、WanFang Data、SinoMed和中华医学会杂志社（新型冠状病毒防控和诊治专栏）等数据库，根据文献研究特点和需要，设置快速检索策略和时限，对符合纳入标准的研究中的药物治疗部分进行总结和描述性分析。结果：最终纳入11篇报告儿童病例的研究或综述（共196例患儿）和8篇指南，对儿童SARS/MERS感染的药物治疗经验进行综述。截止目前，已报道儿童感染病例的药物治疗方案基本依从儿童SARS-CoV-2感染指南推荐，且与既往发表的儿童SARS/MERS的药物治疗经验基本一致，α-干扰素为最常应用和最多推荐的抗病毒药物，其他抗病毒药物的应用多参考成人用法，有效性和安全性需要临床研究进一步予以证实；糖皮质激素和人免疫球蛋白在重症患儿中的应用尚存在争议，需权衡利弊谨慎使用；抗菌药物治疗需严格把握用药指征；其他治疗（如中医药）同样需要更多数据予以支持。结论：目前对于儿童SARS-CoV-2感染，尚无确证有效的药物治疗方案，这与儿童SARS/MERS的药物治疗经验基本一致，药物治疗方案的制定仍需进一步临床试验数据和用药经验总结的支持。 |
| 关键词: 新型冠状病毒 SARS-CoV-2 儿童 药物治疗 指南 |
| DOI：doi:10.13407/ j.cnki.jpp.1672.108X.2020.04.007 |
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| 基金项目: |
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| Rapid Evidence-Based Evaluation of Drug Therapy for Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children |
| Zhou Pengxiang1,2, Zhou Wei1, Liu Ling1, Zhang Yahui1,3, Yang Li1,2 |
| (1. Peking University Third Hospital, Beijing 100191, China; 2. Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China; 3. Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China) |
| Abstract: |
| Objective: To summarize and analyze the currently published literature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Children, clinical practice guidelines or expert consensus and experience in drug therapy of SARS/MERS infection in children based on evidence-based evaluation and literature review, so as to provide evidence-based basis for the formulation of drug therapy for children with SARS-CoV-2 infection. Methods: PubMed, EMBase, the Cochrane Library, CNKI (including the special database of corona virus disease 2019), WanFang Data, SinoMed, and the Chinese Medical Association Journal (column of prevention, control and diagnosis of SARS-CoV-2) were systematically retrieved. According to the characteristics and needs of the literature research, the rapid retrieval strategy and time limit were set up to summarize and descriptively analyze the drug therapy that met the inclusion criteria. Results: Totally 11 literature and pediatric cases reports (196 children) and 8 pediatric clinical practice guidelines or expert consensus were included. The medical therapeutic experience of children with SARS/MERS infection were reviewed. Up to now, the drug therapy regimens for reported cases were basically complied with the recommendation of SARS-CoV-2 infection guidelines for children and consistent with the previously published drug therapy experience for children with SARS/MERS. Alpha-interferon was the most commonly used and recommended. The use of other antiviral drugs mostly referred to the drug use of adults, the effectiveness and safety need to be further confirmed by clinical studies. The application of glucocorticoids and human immunoglobulins in children with severe infection was still controversial, and the pros and cons need to be weighed and used with caution. The indication of antibiotics treatment should be strictly controlled. Other treatments, such as traditional Chinese medicine, also need more supportive data. Conclusion: At present, for children with SARS-CoV-2 infection, there is no confirmed effective drug therapy regimens, which is basically consistent with the treatment experience of SARS/MERS. Development of drug therapy regimens for SARS-CoV-2 infection in children still requires further clinical trial data and experience. |
| Key words: corona virus disease 2019 severe acute respiratory syndrome coronavirus 2 children drug therapy guideline |
