在COVID-19患者中治愈治疗:叙述性审查
Thibault Sixt1, Florian Moretto1, Clementine Esteve1
1Infectious Diseases Department, Dijon-Bourgogne University Hospital, 21000 Dijon, France.
Journal of clinical medicine
|July 29, 2023
概括
评估COVID-19治疗方法显示,被动免疫和抗病毒药物,如与里托纳维尔 (ritonavir) 增强的尼马特里尔维尔 (nirmatrelvir) 早期有效. 对于需要氧气的住院患者来说,抗炎药物,特别是德甲,至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 自2019年12月以来,许多药物,包括重新设计和新型药物,已被调查用于治疗COVID-19.
- 治疗方法根据机制被广泛分类:被动免疫,直接抗病毒药物和抗炎疗法,使用方式取决于疾病阶段.
- 许多评估的治疗方法已经显示出有限的临床益处,并且由于新出现的SARS-CoV-2变种,一些疗效已经减弱.
研究的目的:
- 截至2022年7月14日,审查和总结有关COVID-19治疗选择的现有数据.
- 专注于治疗活跃的COVID-19感染,不包括疫苗等预防措施.
- 根据疾病严重程度和病毒变异来评估不同治疗类别的疗效.
主要方法:
- 关于COVID-19治疗方法的已公布数据的叙事审查.
- 根据作用机制对治疗方法的分类 (被动免疫,直接抗病毒药物,抗炎药).
- 与疾病阶段,患者状况 (门诊/住院),氧气需求和SARS-CoV-2变种相关的治疗有效性的分析.
主要成果:
- 被动免疫,特别是单克隆抗体,在门诊患者和不依赖氧气的住院患者中显示出临床益处,尽管有效性因SARS-CoV-2变种而异.
- 里托纳维尔增强的涅马特里尔维尔是早期感染的首选,替代品是雷梅西维尔,尽管药物相互作用可能会限制涅马特里尔维尔的使用.
- 抗炎药物治疗,特别是德克萨米他,在依赖氧气的住院患者中非常有效;托西利祖马布,JAK抑制剂和阿纳金拉在高炎症病例中表现有前途.
结论:
- 最佳的COVID-19治疗策略仍在发展,需要进一步定义.
- 持续的药物开发和病毒进化的动态性质需要不断重新评估治疗方法.
- 治疗决策必须考虑疾病阶段,患者状况以及涉及的特定SARS-CoV-2变种.
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