Цитата(Yar @ 6.11.2020, 23:26)
я вроде кидал мегаподборку с кучей ссылок.
вот, например, отсюда можно стартовать
https://www.facebook.com/veniamin.zaycev/po...930131310354932там среди прочего есть ссылки на
протоколы лечения второй стадии от нашего МГУ (которые кажутся весьма разумными), но вторая стадия — это уже серьезно и требует обсуждения с врачом.
кроме этого здесь вроде АнтонА выкладывал ссылку на текущие руководящие документы нашего минздрава.
вот конкретно про снижение на 60% на фоне малых доз HQC
https://www.facebook.com/veniamin.zaycev/po...300716979963028вот про цинк
https://www.facebook.com/veniamin.zaycev/po...295564520478274я даю ссыки на ФБ Зайцева потому что он много чего собирает и частично переводит, но есть и другие источники.
я почему спрашиваю, у меня например есть другие ссылки на метаанализ
https://www.bmj.com/content/370/bmj.m2980Цитата
Mortality
Twenty-three randomised controlled trials including 11 620 participants222334394041424446474849505253545557585960616263666972758485 reported mortality. The treatment nodes included in the network meta-analysis were favipiravir, glucocorticoids, hydroxychloroquine, hydroxychloroquine plus azithromycin, lopinavir-ritonavir, remdesivir, umifenovir, and standard care. Fixed effects network meta-analysis showed that fewer patients randomised to glucocorticoids (odds ratio 0.87, 95% credible interval 0.77 to 0.98; risk difference 31 fewer per 1000, 95% credible interval 55 fewer to 5 fewer; moderate certainty) and remdesivir (odds ratio 0.64, 0.43 to 0.94; risk difference 91 fewer per 1000, 154 fewer to 14 fewer; very low certainty) died than those randomised to standard care (fig 2). Patients randomised to hydroxychloroquine did not have a lower risk of death than those randomised to standard care (odds ratio 1.06, 0.93 to 1.21; risk difference 13 more per 1000, 16 fewer to 43 more; low certainty of no benefit). 95% credible intervals included both substantial benefit and harm for hydroxychloroquine plus azithromycin, and lopinavir-ritonavir (both very low certainty). Random effects network meta-analysis led to substantially wider credible intervals for all treatments; compared with standard care, glucocorticoids (odds ratio 0.89, 0.64 to 1.40), hydroxychloroquine (odds ratio 1.08, 0.77 to 1.60), and remdesivir (odds ratio 0.66, 0.41 to 1.09) (see supplementary material). The effect estimates were similar regardless of whether RECOVERY3435 was considered a single three-arm trial or two two-arm trials (see supplementary material).
Mechanical ventilation
Twelve randomised controlled trials including 9083 participants22233435394044464752535862668485 reported mechanical ventilation. The treatment nodes included in the network meta-analysis were glucocorticoids, hydroxychloroquine, hydroxychloroquine plus azithromycin, remdesivir, and standard care (fig 2). Compared with standard care, glucocorticoids probably reduce risk of mechanical ventilation (odds ratio 0.73, 0.58 to 0.92; risk difference 28 fewer per 1000, 45 fewer to 9 fewer; moderate certainty for risk of bias), while hydroxychloroquine probably does not reduce risk of mechanical ventilation (odds ratio 1.19, 0.96 to 1.47; risk difference 19 more per 1000, 4 fewer to 46 more; moderate certainty for risk of bias). Evidence for was less certain for remdesivir (odds ratio 0.78, 0.57 to 1.08; risk difference 23 fewer per 1000, 47 fewer to 8 more; low certainty) and hydroxychloroquine plus azithromycin (odds ratio 1.60, 0.86 to 2.93; risk difference 57 more per 1000, 15 fewer to 162 more; low certainty). Random effects network meta-analysis led to substantially wider credible intervals for all treatments; compared with standard care, glucocorticoids (odds ratio 0.78, 0.48 to 1.56), hydroxychloroquine (odds ratio 1.23, 0.76 to 2.18), hydroxychloroquine plus azithromycin (odds ratio 1.65, 0.72 to 3.88), and remdesivir (odds ratio 0.77, 0.43 to 1.36) (see supplementary material). The effects were similar regardless of whether RECOVERY was considered a single three-arm trial or two two-arm trials (see supplementary material).
Adverse events leading to discontinuation
Thirteen randomised controlled trials including 1938 participants222343444648495051545557586672757685 reported adverse effects leading to discontinuation of the study drug. The treatment nodes included in the network meta-analysis were hydroxychloroquine, remdesivir, and standard care. Moderate certainty evidence showed that remdesivir did not result in a substantial increase in adverse effects leading to drug discontinuation compared with standard care (odds ratio 1.27, 0.51 to 4.07; risk difference 4 more per 1000, 7 fewer to 43 more). Certainty in evidence for hydroxychloroquine was very low (fig 2).
Viral clearance at 7 days (3 days either way)
Eleven randomised controlled trials including 876 participants2339424749505154555657637285 measured viral clearance with polymerase chain reaction cut-off points. The treatment nodes included in the network meta-analysis were hydroxychloroquine, lopinavir-ritonavir, remdesivir, and standard care. We did not find any convincing evidence that any of the interventions increased the rate of viral clearance (fig 2). The certainty of the evidence was low for remdesivir compared with standard care, and very low for all other comparisons.
Admission to hospital
Two randomised controlled trials enrolling 551 participants5960 reported admission to hospital in patients who were outpatients at baseline. One study of hydroxychloroquine versus placebo was included.60 There were too few events to make any inferences with (odds ratio 0.52, 0.16 to 1.68; risk difference 19 fewer per 1000, 43 fewer to 26 more; low certainty) (fig 2).
Duration of hospital stay
Thirteen randomised controlled trials including 9631 participants2334353940424446525456575862636685 reported duration of hospital stay. The treatment nodes included in the network meta-analysis were glucocorticoids, hydroxychloroquine, hydroxychloroquine plus azithromycin, lopinavir-ritonavir, remdesivir, and standard care. Compared with standard care, duration of hospitalisation was shorter in patients who received glucocorticoids (mean difference −0.99 days, −1.36 to −0.64; moderate certainty) and lopinavir-ritonavir (mean difference −1.33 days, −2.38 to −0.29; low certainty). There was no evidence that hydroxychloroquine (very low certainty), hydroxychloroquine plus azithromycin (low certainty), or remdesivir (low certainty) decrease length of stay (fig 2).
