Immune-Based Therapy for Hospitalized Patients With COVID-19 and Risk of Secondary Infections: A Systematic Review and Meta-analysis.
COVID-19
immunotherapy
secondary infection
Journal
Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
31
05
2022
accepted:
05
12
2022
entrez:
11
1
2023
pubmed:
12
1
2023
medline:
12
1
2023
Statut:
epublish
Résumé
Immune-based therapies are standard-of-care treatment for coronavirus disease 2019 (COVID-19) patients requiring hospitalization. However, safety concerns related to the potential risk of secondary infections may limit their use. We searched OVID Medline, Ovid EMBASE, SCOPUS, Cochrane Library, clinicaltrials.gov, and PROSPERO in October 2020 and updated the search in November 2021. We included randomized controlled trials (RCTs). Pairs of reviewers screened abstracts and full studies and extracted data in an independent manner. We used RevMan to conduct a meta-analysis using random-effects models to calculate the pooled risk ratio (RR) and 95% CI for the incidence of infection. Statistical heterogeneity was determined using the This was a meta-analysis of 37 RCTs including 32 621 participants (mean age, 60 years; 64% male). The use of immune-based therapy for COVID-19 conferred mild protection for the occurrence of secondary infections (711/15 721, 4.5%, vs 616/16 900, 3.6%; RR, 0.82; 95% CI, 0.71-0.95; We identified moderate-certainty evidence that the use of immune-based therapies in COVID-19 requiring hospitalization does not increase the risk of secondary infections.
Sections du résumé
Background
UNASSIGNED
Immune-based therapies are standard-of-care treatment for coronavirus disease 2019 (COVID-19) patients requiring hospitalization. However, safety concerns related to the potential risk of secondary infections may limit their use.
Methods
UNASSIGNED
We searched OVID Medline, Ovid EMBASE, SCOPUS, Cochrane Library, clinicaltrials.gov, and PROSPERO in October 2020 and updated the search in November 2021. We included randomized controlled trials (RCTs). Pairs of reviewers screened abstracts and full studies and extracted data in an independent manner. We used RevMan to conduct a meta-analysis using random-effects models to calculate the pooled risk ratio (RR) and 95% CI for the incidence of infection. Statistical heterogeneity was determined using the
Results
UNASSIGNED
This was a meta-analysis of 37 RCTs including 32 621 participants (mean age, 60 years; 64% male). The use of immune-based therapy for COVID-19 conferred mild protection for the occurrence of secondary infections (711/15 721, 4.5%, vs 616/16 900, 3.6%; RR, 0.82; 95% CI, 0.71-0.95;
Conclusions
UNASSIGNED
We identified moderate-certainty evidence that the use of immune-based therapies in COVID-19 requiring hospitalization does not increase the risk of secondary infections.
Identifiants
pubmed: 36628058
doi: 10.1093/ofid/ofac655
pii: ofac655
pmc: PMC9825199
doi:
Types de publication
Journal Article
Langues
eng
Pagination
ofac655Subventions
Organisme : FIC NIH HHS
ID : D43 TW009118
Pays : United States
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Déclaration de conflit d'intérêts
Potential conflicts of interest. The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declare no competing interests. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Références
N Engl J Med. 2021 Feb 25;384(8):693-704
pubmed: 32678530
J Clin Epidemiol. 2013 Feb;66(2):151-7
pubmed: 22542023
Respiration. 2021;100(2):116-126
pubmed: 33486496
PLoS Med. 2006 Sep;3(9):e343
pubmed: 16968120
JAMA. 2020 Oct 6;324(13):1307-1316
pubmed: 32876695
Am J Health Syst Pharm. 2008 Aug 1;65(15):1413-8
pubmed: 18653811
JAMA. 2020 Jun 9;323(22):2329-2330
pubmed: 32329799
J Med Libr Assoc. 2006 Apr;94(2):130-6
pubmed: 16636704
BMC Med. 2004 Jun 09;2:23
pubmed: 15189561
N Engl J Med. 2021 Apr 22;384(16):1491-1502
pubmed: 33631065
Lancet Respir Med. 2021 Mar;9(3):295-304
pubmed: 33493450
BMJ. 2017 Apr 12;357:j1415
pubmed: 28404617
Lancet. 2021 May 01;397(10285):1637-1645
pubmed: 33933206
JAMA Intern Med. 2021 Jan 1;181(1):24-31
pubmed: 33080005
Lancet Respir Med. 2021 Dec;9(12):1365-1376
pubmed: 34672949
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Lancet Respir Med. 2021 Sep;9(9):957-968
pubmed: 34147142
Am J Hematol. 2018 Mar;93(3):339-347
pubmed: 29150886
Inflamm Res. 2021 Dec;70(10-12):1233-1246
pubmed: 34586459
J Allergy Clin Immunol. 2020 Jul;146(1):137-146.e3
pubmed: 32470486
Lancet Respir Med. 2021 Dec;9(12):1407-1418
pubmed: 34480861
JAMA. 2020 Oct 6;324(13):1317-1329
pubmed: 32876697
JAMA. 2020 Oct 6;324(13):1330-1341
pubmed: 32876694
Lancet Respir Med. 2021 Dec;9(12):1419-1426
pubmed: 34672950
Expert Opin Biol Ther. 2021 May;21(5):675-686
pubmed: 33835886
Nat Med. 2021 Oct;27(10):1752-1760
pubmed: 34480127
Clin Transl Immunology. 2020 Nov 25;9(11):e1218
pubmed: 33304584
N Engl J Med. 2021 Jul 29;385(5):406-415
pubmed: 34133856
Lancet Rheumatol. 2020 Dec;2(12):e764-e773
pubmed: 33015643
Res Synth Methods. 2021 Jan;12(1):55-61
pubmed: 32336025
Lancet Rheumatol. 2021 Jun;3(6):e410-e418
pubmed: 33754144
Intensive Care Med. 2021 Nov;47(11):1258-1270
pubmed: 34609549
Infect Dis Ther. 2021 Dec;10(4):2735-2748
pubmed: 34658006
N Engl J Med. 2021 Mar 4;384(9):795-807
pubmed: 33306283
BMJ. 2021 Jan 20;372:n84
pubmed: 33472855
Int Immunopharmacol. 2020 Nov;88:106903
pubmed: 32862111
Lancet Respir Med. 2021 May;9(5):511-521
pubmed: 33676589
Crit Care. 2019 Mar 27;23(1):99
pubmed: 30917856
N Engl J Med. 2020 Dec 10;383(24):2333-2344
pubmed: 33085857
Lancet Respir Med. 2021 May;9(5):522-532
pubmed: 33676590
Clin Infect Dis. 2021 May 4;72(9):e373-e381
pubmed: 32785710
Eur Respir J. 2020 Dec 24;56(6):
pubmed: 32943404
Mayo Clin Proc. 2020 Jul;95(7):1404-1419
pubmed: 32499126
Cochrane Database Syst Rev. 2019 Feb 24;2:CD010406
pubmed: 30798570
JAMA Intern Med. 2021 Jan 1;181(1):32-40
pubmed: 33080017
J Cardiothorac Vasc Anesth. 2021 Feb;35(2):578-584
pubmed: 33298370
JAMA. 2020 Oct 6;324(13):1298-1306
pubmed: 32876689
Rheumatology (Oxford). 2011 Mar;50(3):552-62
pubmed: 21078627
RMD Open. 2021 Feb;7(1):
pubmed: 33542047
Cell Host Microbe. 2020 Jun 10;27(6):992-1000.e3
pubmed: 32320677
Clin Microbiol Infect. 2021 Feb;27(2):215-227
pubmed: 33161150
Cochrane Database Syst Rev. 2011 Feb 16;(2):CD008794
pubmed: 21328309
Wien Klin Wochenschr. 2021 Apr;133(7-8):303-311
pubmed: 33534047
N Engl J Med. 2021 Apr 22;384(16):1503-1516
pubmed: 33631066
N Engl J Med. 2021 Jan 7;384(1):20-30
pubmed: 33332779
Antimicrob Agents Chemother. 2020 Aug 20;64(9):
pubmed: 32661006
Leukemia. 2020 Jun;34(6):1503-1511
pubmed: 32372026
JAMA. 2021 Jul 20;326(3):230-239
pubmed: 34283183