心血管系统常用药物对新型冠状病毒肺炎感染风险及不良预后的影响

doi:10.3969/j.issn.1004-583X.2022.10.001

摘要/Abstract

摘要：

心血管疾病是新型冠状病毒肺炎(新冠肺炎)最为常见的合并症,在新冠肺炎大流行期间降压、降脂、抗血小板、抗凝、降糖及抗心律失常等心血管系统常用药物的安全性和有效性尚未形成统一明确的认识, 相关指南也有待进一步完善。随着全球新冠肺炎病例数量的增加和第二波感染的发生,更好地了解这些药物对新冠肺炎患者的影响是当务之急。本文旨在总结心血管系统常用药物对新冠肺炎感染风险以及不良预后的关联,并对合并心血管疾病的新冠肺炎患者用药提出建议。

关键词: 新型冠状病毒肺炎, 心血管系统, 抗凝治疗, 抗血小板治疗, 降脂治疗, 降压治疗, 降糖治疗, 抗心律失常, 荟萃分析

Abstract:

Cardiovascular disease is the most-common complication of coronavirus disease 2019 (COVID-19). During the COVID-19 pandemic, the safety and efficacy of common cardiovascular drugs such as anti-hypertensive, lipid-lowering, antiplatelet, anticoagulant, hypoglycemic and antiarrhythmic drugs have remained controversial that required improved consensuses. With the increase of global cases of COVID-19 and the occurrence of the second wave of infection, it is urgent to reveal the effects of cardiovascular disease drugs on COVID-19 patients. This study aims to summarize the relationship between common cardiovascular drugs and the risk of COVID-19 infection and poor prognosis, thus providing references for medications in COVID-19 patients with cardiovascular diseases.

Key words: COVID-19, cardiovascular system, anticoagulant therapy, antiplatelet therapy, lipid-lowering therapy, anti-hypertensive therapy, hypoglycemic therapy, antiarrhythmic therapy, meta-analysis

中图分类号:

R563.12

周子涵, 崔炜. 心血管系统常用药物对新型冠状病毒肺炎感染风险及不良预后的影响[J]. 临床荟萃, 2022, 37(10): 869-888.

Zhou Zihan, Cui Wei. Effects of common cardiovascular drugs on the risk of COVID-19 infection and poor prognosis[J]. Clinical Focus, 2022, 37(10): 869-888.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.10.001

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I10/869

图/表 5

参考文献 144

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作者	研究人群	分组		研究数量	研究人数	发病风险	进展为重型/ 危重型肺炎	入住ICU	机械通气/高级生命支持	死亡率
作者	研究人群	试验组	对照组	研究数量	研究人数	发病风险	进展为重型/ 危重型肺炎	入住ICU	机械通气/高级生命支持	死亡率
Koshy等^[4]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	6项研究(5项队列研究、1项病例对照研究)	73 122	无关	无关			无关
Chu等^[5]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	48项研究(41项队列研究、1项随机对照研究、6项病例对照研究)	237 169	降低		降低	降低	降低
Tleyjeh等^[6]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	10项研究(6项队列研究、4项病例对照研究)	277 264	无关
Xu等^[7]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	49项研究(24项队列研究、25项病例对照研究、1项随机对照研究)	1 242 953	未调整增加, 调整后无关	未调整增加, 调整后无关	未调整增加, 调整后无关	未调整增加, 调整后无关	未调整无关, 调整后无关
Zhang等^[8]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	12项研究(7项队列研究、5项病例对照研究)	19 000⁺	无关	无关			无关
	新冠肺炎合并高血压患者						无关			降低
Asiimwe等^[9]	普通人群及新冠肺炎患者	ACEIs/ARBs等	非ACEIs/ARBs 用药	390项研究(388项观察性研究、2项随机对照研究)	10 000 000⁺	未调整无关, 调整后无关	未调整增加, 调整后降低			未调整增加, 调整后降低
	新冠肺炎合并高血压患者					无关	无关			降低
Liu等^[10]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	11项研究(9项回顾性研究,2项病例对照研究)	33 483	无关	降低			降低
	新冠肺炎合并高血压患者					无关	无关			降低
Caldeira等^[11]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	27项研究(22项队列研究、4项病例对照研究、1项随机对照研究)	119 656	未调整无关, 调整后无关	未调整无关, 调整后无关			未调整无关, 调整后无关
	新冠肺炎合并高血压患者					无关	无关			降低
Ren等^[12]	普通人群及新冠肺炎患者	ACEIs/ARBs等	非ACEIs/ARBs 用药	53项研究(39项队列研究、14项病例对照研究)	2100 587	无关	无关	无关		无关
	新冠肺炎合并高血压患者	ACEIs/ARBs				无关	降低			降低
Yokoyama等^[13]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	17项研究(未注明研究类型)	77 021	无关				无关
	新冠肺炎合并高血压患者									降低
Lee等^[14]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	86项观察性研究	459 577	无关	无关	增加	增加	增加
	新冠肺炎合并高血压患者					无关	无关	无关	无关	无关
Ma等^[15]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	16项病例对照研究	116 111	未调整增加, 调整后无关	无关		无关	无关
	新冠肺炎合并高血压患者					无关
Asiimwe等^[16]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	10项随机对照研究	1 906	无关		无关	无关	无关
	新冠肺炎合并高血压患者							无关	无关	无关
Grover等^[18]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	16项研究(未注明研究类型)	123 576		降低			降低
Hasan等^[19]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	29研究(未注明研究类型)	48 856		无关			降低
Greco等^[20]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	14项研究(13项观察性研究、1项随机临床试验)	10 127		无关			无关
Lo等^[21]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	21项研究(19项队列研究、1项病例系列、1项病例对照研究)	24 191		无关			无关
Alamer等^[22]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	30项回顾性观察性研究	37 144		未调整无关, 调整后无关	未调整无关, 调整后无关	未调整无关, 调整后无关	未调整无关, 调整后无关
Lee等^[23]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	20项研究(未注明研究类型)	30 766		无关			降低
Hassib等^[24]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	8项研究(5项回顾性研究,2项队列研究,1项病例对照研究)	17 943		无关	无关	无关	无关
Bavishi等^[25]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	34项研究(31项队列研究,3项病例对照研究)	94 977		调整后无关	调整后无关	调整后无关	调整后无关
Xie等^[26]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	13项回顾性研究	10 434		降低			降低
Sattar等^[27]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	49项研究(41项回顾性研究、8项前瞻性研究)	83 269		无关	无关		无关
Fernando等^[28]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	26项队列研究	29 378		增加			无关
Baral等^[29]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	19项研究(12项队列研究、4项病例系列、3项病例对照研究)	28 872		降低			降低
	新冠肺炎合并高血压患者						降低			降低
Castelnuovo等^[30]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	19项回顾性观察性研究	29 057		无关	无关	无关	无关
	新冠肺炎合并高血压患者						无关	无关	无关	无关
Guo等^[31]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	9项研究(未标注研究类型)	3 936		无关			降低
Pranata等^[32]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs用药	15项回顾性研究	7 410		无关			无关
Barochiner等^[33]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	18项队列研究	17 311		降低	降低	降低	降低
Wang等^[34]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	26项队列研究	16 307		降低	降低	降低	降低
Dai等^[35]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	42项观察性研究	63 893		无关			无关
Yin等^[39]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	7项随机对照研究	1 321			无关	无关	无关
		ARBs						降低	降低	降低
Singh等^[40]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	68项研究(48项队列研究,20项病例对照研究)	133 402			无关	无关	无关
Gnanenthiran等^[41]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	14项随机对照研究	1 838			无关	无关	无关
Baral等^[42]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	52项研究(40项队列研究、6项病例系列、4项病例对照研究、1项随机临床试验、1项横断面研究)	101 949			调整后降低	调整后降低	调整后降低
	新冠肺炎合并高血压患者							降低	降低	降低
Aparisi等^[43]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	14项回顾性研究	5 213			无关	无关	降低
Loader等^[44]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	2项观察性研究	1 351 642				降低	降低
Qiu等^[45]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	9项研究(未注明研究类型)	7 789					无关
Lee等^[46]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	30项研究(未注明研究类型)	17 282					未调整无关, 调整后下降
Azad等^[47]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	6项研究(5项观察性性研究、1项病例系列)	1 566					无关
Kow等^[48]	新冠肺炎患者	ARBs	非ARBs用药	3项随机对照研究	443					无关
Sharma等^[49]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	68项研究(56项队列研究、12项病例对照研究)	128 078					无关
Ssentongo等^[50]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	14项队列研究	73 073					降低
Laurentius等^[51]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	10项回顾性观察性研究	19 073					无关
Lu等^[12]	新冠肺炎患者	CCBs	非CCBs用药	10项研究(3项队列研究、6项病例对照研究、1项回顾性研究)	427 749	无关	无关
Alsagaff等^[36]	新冠肺炎患者	CCBs	非CCBs用药	31项研究(27项回顾性研究、4项前瞻性观察研究)	119 298		无关	无关	无关	无关
	新冠肺炎合并高血压患者						无关	无关	无关	降低
Kow等^[37]	新冠肺炎合并高血压患者	CCBs	非CCBs用药	9项回顾性研究	18 835		降低	降低	降低	降低
Kow等^[38]	新冠肺炎患者	CCBs	非CCBs用药	23项研究(22项回顾性研究、1项前瞻性观察研究)	127 082		无关	无关	无关	无关
Lu等^[12]	新冠肺炎患者	β受体阻滞剂	非β受体阻滞剂用药	10项研究(5项队列研究、5项病例对照研究)	424 324	无关	无关
Hariyanto等^[17]	新冠肺炎患者	β受体阻滞剂	非β受体阻滞剂用药	43项研究(31项回顾性队列研究、7项前瞻性队列研究、5项研究病例对照研究)	11 388 556	增加	增加	增加	增加	增加
Lu等^[12]	新冠肺炎患者	利尿剂	非利尿剂用药	7项研究(4项队列研究、3项病例对照研究)	422 852	无关	无关

作者	研究人群	分组		研究数量	研究人数	发病风险	进展为重型/ 危重型肺炎	入住ICU	机械通气/高级生命支持	死亡率
作者	研究人群	试验组	对照组	研究数量	研究人数	发病风险	进展为重型/ 危重型肺炎	入住ICU	机械通气/高级生命支持	死亡率
Koshy等^[4]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	6项研究(5项队列研究、1项病例对照研究)	73 122	无关	无关			无关
Chu等^[5]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	48项研究(41项队列研究、1项随机对照研究、6项病例对照研究)	237 169	降低		降低	降低	降低
Tleyjeh等^[6]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	10项研究(6项队列研究、4项病例对照研究)	277 264	无关
Xu等^[7]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	49项研究(24项队列研究、25项病例对照研究、1项随机对照研究)	1 242 953	未调整增加, 调整后无关	未调整增加, 调整后无关	未调整增加, 调整后无关	未调整增加, 调整后无关	未调整无关, 调整后无关
Zhang等^[8]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	12项研究(7项队列研究、5项病例对照研究)	19 000⁺	无关	无关			无关
	新冠肺炎合并高血压患者						无关			降低
Asiimwe等^[9]	普通人群及新冠肺炎患者	ACEIs/ARBs等	非ACEIs/ARBs 用药	390项研究(388项观察性研究、2项随机对照研究)	10 000 000⁺	未调整无关, 调整后无关	未调整增加, 调整后降低			未调整增加, 调整后降低
	新冠肺炎合并高血压患者					无关	无关			降低
Liu等^[10]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	11项研究(9项回顾性研究,2项病例对照研究)	33 483	无关	降低			降低
	新冠肺炎合并高血压患者					无关	无关			降低
Caldeira等^[11]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	27项研究(22项队列研究、4项病例对照研究、1项随机对照研究)	119 656	未调整无关, 调整后无关	未调整无关, 调整后无关			未调整无关, 调整后无关
	新冠肺炎合并高血压患者					无关	无关			降低
Ren等^[12]	普通人群及新冠肺炎患者	ACEIs/ARBs等	非ACEIs/ARBs 用药	53项研究(39项队列研究、14项病例对照研究)	2100 587	无关	无关	无关		无关
	新冠肺炎合并高血压患者	ACEIs/ARBs				无关	降低			降低
Yokoyama等^[13]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	17项研究(未注明研究类型)	77 021	无关				无关
	新冠肺炎合并高血压患者									降低
Lee等^[14]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	86项观察性研究	459 577	无关	无关	增加	增加	增加
	新冠肺炎合并高血压患者					无关	无关	无关	无关	无关
Ma等^[15]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	16项病例对照研究	116 111	未调整增加, 调整后无关	无关		无关	无关
	新冠肺炎合并高血压患者					无关
Asiimwe等^[16]	普通人群及新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	10项随机对照研究	1 906	无关		无关	无关	无关
	新冠肺炎合并高血压患者							无关	无关	无关
Grover等^[18]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	16项研究(未注明研究类型)	123 576		降低			降低
Hasan等^[19]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	29研究(未注明研究类型)	48 856		无关			降低
Greco等^[20]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	14项研究(13项观察性研究、1项随机临床试验)	10 127		无关			无关
Lo等^[21]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	21项研究(19项队列研究、1项病例系列、1项病例对照研究)	24 191		无关			无关
Alamer等^[22]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	30项回顾性观察性研究	37 144		未调整无关, 调整后无关	未调整无关, 调整后无关	未调整无关, 调整后无关	未调整无关, 调整后无关
Lee等^[23]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	20项研究(未注明研究类型)	30 766		无关			降低
Hassib等^[24]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	8项研究(5项回顾性研究,2项队列研究,1项病例对照研究)	17 943		无关	无关	无关	无关
Bavishi等^[25]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	34项研究(31项队列研究,3项病例对照研究)	94 977		调整后无关	调整后无关	调整后无关	调整后无关
Xie等^[26]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	13项回顾性研究	10 434		降低			降低
Sattar等^[27]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	49项研究(41项回顾性研究、8项前瞻性研究)	83 269		无关	无关		无关
Fernando等^[28]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	26项队列研究	29 378		增加			无关
Baral等^[29]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	19项研究(12项队列研究、4项病例系列、3项病例对照研究)	28 872		降低			降低
	新冠肺炎合并高血压患者						降低			降低
Castelnuovo等^[30]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	19项回顾性观察性研究	29 057		无关	无关	无关	无关
	新冠肺炎合并高血压患者						无关	无关	无关	无关
Guo等^[31]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	9项研究(未标注研究类型)	3 936		无关			降低
Pranata等^[32]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs用药	15项回顾性研究	7 410		无关			无关
Barochiner等^[33]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	18项队列研究	17 311		降低	降低	降低	降低
Wang等^[34]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	26项队列研究	16 307		降低	降低	降低	降低
Dai等^[35]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	42项观察性研究	63 893		无关			无关
Yin等^[39]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	7项随机对照研究	1 321			无关	无关	无关
		ARBs						降低	降低	降低
Singh等^[40]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	68项研究(48项队列研究,20项病例对照研究)	133 402			无关	无关	无关
Gnanenthiran等^[41]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	14项随机对照研究	1 838			无关	无关	无关
Baral等^[42]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	52项研究(40项队列研究、6项病例系列、4项病例对照研究、1项随机临床试验、1项横断面研究)	101 949			调整后降低	调整后降低	调整后降低
	新冠肺炎合并高血压患者							降低	降低	降低
Aparisi等^[43]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	14项回顾性研究	5 213			无关	无关	降低
Loader等^[44]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	2项观察性研究	1 351 642				降低	降低
Qiu等^[45]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	9项研究(未注明研究类型)	7 789					无关
Lee等^[46]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	30项研究(未注明研究类型)	17 282					未调整无关, 调整后下降
Azad等^[47]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	6项研究(5项观察性性研究、1项病例系列)	1 566					无关
Kow等^[48]	新冠肺炎患者	ARBs	非ARBs用药	3项随机对照研究	443					无关
Sharma等^[49]	新冠肺炎患者	ACEIs/ARBs	非ACEIs/ARBs 用药	68项研究(56项队列研究、12项病例对照研究)	128 078					无关
Ssentongo等^[50]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	14项队列研究	73 073					降低
Laurentius等^[51]	新冠肺炎合并高血压患者	ACEIs/ARBs	非ACEIs/ARBs 用药	10项回顾性观察性研究	19 073					无关
Lu等^[12]	新冠肺炎患者	CCBs	非CCBs用药	10项研究(3项队列研究、6项病例对照研究、1项回顾性研究)	427 749	无关	无关
Alsagaff等^[36]	新冠肺炎患者	CCBs	非CCBs用药	31项研究(27项回顾性研究、4项前瞻性观察研究)	119 298		无关	无关	无关	无关
	新冠肺炎合并高血压患者						无关	无关	无关	降低
Kow等^[37]	新冠肺炎合并高血压患者	CCBs	非CCBs用药	9项回顾性研究	18 835		降低	降低	降低	降低
Kow等^[38]	新冠肺炎患者	CCBs	非CCBs用药	23项研究(22项回顾性研究、1项前瞻性观察研究)	127 082		无关	无关	无关	无关
Lu等^[12]	新冠肺炎患者	β受体阻滞剂	非β受体阻滞剂用药	10项研究(5项队列研究、5项病例对照研究)	424 324	无关	无关
Hariyanto等^[17]	新冠肺炎患者	β受体阻滞剂	非β受体阻滞剂用药	43项研究(31项回顾性队列研究、7项前瞻性队列研究、5项研究病例对照研究)	11 388 556	增加	增加	增加	增加	增加
Lu等^[12]	新冠肺炎患者	利尿剂	非利尿剂用药	7项研究(4项队列研究、3项病例对照研究)	422 852	无关	无关

作者	研究人群	分组		研究数量	研究人数	发病风险	进展为重型/危重型肺炎	入住ICU	机械通气/高级生命支持	死亡率
作者	研究人群	试验组	对照组	研究数量	研究人数	发病风险	进展为重型/危重型肺炎	入住ICU	机械通气/高级生命支持	死亡率
Hariyanto等^[56]	普通人群及	他汀类药物	非他汀类用药	35项(31项回顾性队列研究,2项前瞻性队列研究,2项病例对照研究)	1 930 583	无关	无关			无关
Hariyanto等^[56]	新冠肺炎患者	他汀类药物	非他汀类用药	35项(31项回顾性队列研究,2项前瞻性队列研究,2项病例对照研究)	1 930 583	无关	无关			无关
Hariyanto等^[57]	新冠肺炎患者	他汀类药物	非他汀类用药	9项(7项回顾性队列研究,1项病例对照研究, 1项病例系列研究)	3 449		无关			无关
Kow等^[58]	新冠肺炎患者	他汀类药物	非他汀类用药	4项回顾性研究	8 990		降低			降低
Scheen等^[59]	新冠肺炎患者	他汀类药物	非他汀类用药	18项回顾性观察性研究	44 795			无关	无关	无关
Onorato等^[60]	新冠肺炎患者	他汀类药物	非他汀类用药	7项回顾性研究	2 398			降低	降低	降低
Wu等^[61]	新冠肺炎患者	他汀类药物	非他汀类用药	22项观察性研究	63 537			无关	降低	降低
Chow等^[62]	新冠肺炎患者	他汀类药物	非他汀类用药	13项回顾性队列研究	110 087			无关	无关	非ICU患者降低,
Chow等^[62]	新冠肺炎患者	他汀类药物	非他汀类用药	13项回顾性队列研究	110 087			无关	无关	入院后接受他汀类药物治疗患者降低
Kow等^[63]	新冠肺炎患者	他汀类药物	非他汀类用药	35项回顾性观察性研究	139 024			调整后降低	调整后降低	调整后降低
Vahedian-Azimi等^[64]	新冠肺炎患者	他汀类药物	非他汀类用药	47项观察性研究	3 238 508			无关	降低	无关
Pal等^[65]	新冠肺炎患者	他汀类药物	非他汀类用药	14项(13项回顾性队列研究,1项病例对照研究)	19 988					调整后降低
Permana等^[66]	新冠肺炎患者	他汀类药物	非他汀类用药	13项(12项回顾性队列研究,1项前瞻性队列研究)	52 122					入院后接受他汀类药物治疗患者降低,
Permana等^[66]	新冠肺炎患者	他汀类药物	非他汀类用药	13项(12项回顾性队列研究,1项前瞻性队列研究)	52 122					入院前接受他汀类药物治疗患者无关
Kollias等^[67]	新冠肺炎患者	他汀类药物	非他汀类用药	22项回顾性观察性研究	114 688					调整后降低
Zein等^[68]	新冠肺炎患者	他汀类药物	非他汀类用药	8项倾向性评分匹配研究	14 446					调整后降低
Diaz-Arocutipa等^[69]	新冠肺炎患者	他汀类药物	非他汀类用药	25项队列研究	147 824					调整后降低

作者	研究人群	分组		研究数量	研究人数	发病风险	进展为重型/危重型肺炎	入住ICU	机械通气/高级生命支持	死亡率
作者	研究人群	试验组	对照组	研究数量	研究人数	发病风险	进展为重型/危重型肺炎	入住ICU	机械通气/高级生命支持	死亡率
Hariyanto等^[56]	普通人群及	他汀类药物	非他汀类用药	35项(31项回顾性队列研究,2项前瞻性队列研究,2项病例对照研究)	1 930 583	无关	无关			无关
Hariyanto等^[56]	新冠肺炎患者	他汀类药物	非他汀类用药	35项(31项回顾性队列研究,2项前瞻性队列研究,2项病例对照研究)	1 930 583	无关	无关			无关
Hariyanto等^[57]	新冠肺炎患者	他汀类药物	非他汀类用药	9项(7项回顾性队列研究,1项病例对照研究, 1项病例系列研究)	3 449		无关			无关
Kow等^[58]	新冠肺炎患者	他汀类药物	非他汀类用药	4项回顾性研究	8 990		降低			降低
Scheen等^[59]	新冠肺炎患者	他汀类药物	非他汀类用药	18项回顾性观察性研究	44 795			无关	无关	无关
Onorato等^[60]	新冠肺炎患者	他汀类药物	非他汀类用药	7项回顾性研究	2 398			降低	降低	降低
Wu等^[61]	新冠肺炎患者	他汀类药物	非他汀类用药	22项观察性研究	63 537			无关	降低	降低
Chow等^[62]	新冠肺炎患者	他汀类药物	非他汀类用药	13项回顾性队列研究	110 087			无关	无关	非ICU患者降低,
Chow等^[62]	新冠肺炎患者	他汀类药物	非他汀类用药	13项回顾性队列研究	110 087			无关	无关	入院后接受他汀类药物治疗患者降低
Kow等^[63]	新冠肺炎患者	他汀类药物	非他汀类用药	35项回顾性观察性研究	139 024			调整后降低	调整后降低	调整后降低
Vahedian-Azimi等^[64]	新冠肺炎患者	他汀类药物	非他汀类用药	47项观察性研究	3 238 508			无关	降低	无关
Pal等^[65]	新冠肺炎患者	他汀类药物	非他汀类用药	14项(13项回顾性队列研究,1项病例对照研究)	19 988					调整后降低
Permana等^[66]	新冠肺炎患者	他汀类药物	非他汀类用药	13项(12项回顾性队列研究,1项前瞻性队列研究)	52 122					入院后接受他汀类药物治疗患者降低,
Permana等^[66]	新冠肺炎患者	他汀类药物	非他汀类用药	13项(12项回顾性队列研究,1项前瞻性队列研究)	52 122					入院前接受他汀类药物治疗患者无关
Kollias等^[67]	新冠肺炎患者	他汀类药物	非他汀类用药	22项回顾性观察性研究	114 688					调整后降低
Zein等^[68]	新冠肺炎患者	他汀类药物	非他汀类用药	8项倾向性评分匹配研究	14 446					调整后降低
Diaz-Arocutipa等^[69]	新冠肺炎患者	他汀类药物	非他汀类用药	25项队列研究	147 824					调整后降低

作者	研究人群	分组		研究数量	研究人数	发病风险	进展为重型/危重型肺炎	入住ICU	机械通气/高级生命支持	血栓事件	出血事件	死亡率
作者	研究人群	试验组	对照组	研究数量	研究人数	发病风险	进展为重型/危重型肺炎	入住ICU	机械通气/高级生命支持	血栓事件	出血事件	死亡率
Wang等^[76]	新冠肺炎患者	阿司匹林等抗血小板药	非抗血小板治疗	9项(7项回顾性研究,2项前瞻性研究)	5 970		无关					未调整增加, 调整后降低
Patoulias等^[77]	新冠肺炎患者	阿司匹林等抗血小板药	非抗血小板治疗	3项随机对照试验	15 782					降低	增加	无关
Ma等^[78]	新冠肺炎患者	阿司匹林	非阿司匹林用药	18项(11项队列研究、3项病例对照研究、3项横断面研究、1项随机对照试验)	49 041	无关					无关	未调整无关, 调整后降低
		低剂量组 (80~100 mg/d)										降低
		中剂量组 (150 mg/d)										无关
Salah等^[79]	新冠肺炎患者	阿司匹林	非阿司匹林用药	3项回顾性研究	1 054							无关
Kow等^[80]	新冠肺炎患者	阿司匹林等抗血小板药	非抗血小板治疗	12项(11项回顾性研究,1项前瞻性研究)	57 227							无关
		阿司匹林	非阿司匹林抗血小板治疗									降低
Martha等^[81]	新冠肺炎患者	阿司匹林	非阿司匹林用药	6项回顾性研究	13 993							调整后降低
Wijaya等^[82]	新冠肺炎患者	阿司匹林	非阿司匹林用药	7项回顾性研究	34 415							降低
Srivastava等^[83]	新冠肺炎患者	阿司匹林	非阿司匹林用药	10项观察性性研究	56 696							降低
Srinivasan等^[84]	新冠肺炎患者	阿司匹林	非阿司匹林用药	14项(13项队列研究、1项随机对照试验)	164 539							降低