专家共识:COVID-19预后不佳的主要风险因素以及针对SARS-CoV-2的有针对性的措施的影响
Francisco Javier Candel1, Pablo Barreiro2,3, Miguel Salavert4
1Clinical Microbiology & Infectious Diseases, Transplant Coordination, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain.
Viruses
|July 29, 2023
概括
一些COVID-19患者从早期抗病毒治疗中受益. 这包括65岁以上有风险因素的人,患有特定癌症的人或晚期艾滋病毒的人,以防止严重的后果.
科学领域:
- 传染性疾病 传染性疾病
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 严重急性呼吸道冠状病毒2型 (SARS-CoV-2) 变种已经演变,增加的人口免疫力减少了流行病的毒性.
- 然而,患有风险因素或并发症的患者仍然容易感染2019年新冠肺炎严重传染病 (COVID-19).
- 早期使用针对病毒的疗法,如抗病毒药物或单克隆抗体,对于管理高风险个体至关重要.
研究的目的:
- 确定患者的特征,包括风险因素和并发症,这些特征表明候选人早期的病毒向治疗COVID-19.
- 建立专家共识,使用可用的针对病毒的措施,以预防严重疾病或死亡.
主要方法:
- 一个全面的文献综述研究发表于2021年7月1日至2022年2月15日之间的研究.
- 专家小组对159项额外研究进行了独立审查.
- 分析的重点是确定强烈推或禁用针对病毒的治疗方法的条件.
主要成果:
- 针对早期病毒向措施的强有力的建议包括年龄>80岁,年龄>65岁与另一个危险因素,活跃的恶性瘤或化疗,CD4+<200/mm3的HIV和抗CD20免疫抑制疗法.
- 强烈的禁忌包括艾滋病毒与CD4+极点<200/mm3或其他免疫抑制治疗.
- 这些指示适用于无论疫苗接种情况或先前感染史.
结论:
- 针对SARS-CoV-2的病毒向疗法仍然适用于特定的高风险人群,即使在世卫组织宣布COVID-19不再是全球卫生紧急情况之后.
- 早期识别和治疗风险人群是缓解COVID-19严重后果的关键.
- 随着病毒和人群免疫力的演变,需要不断评估治疗策略.
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