抗病毒组合治疗严重免疫受损的持续性或复发性COVID-19患者
Keitaro Omori1, Hiroki Kitagawa2, Ayako Takamori3
1Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Kasumi, Hiroshima, 734-8551, Japan; Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Hiroshima, 734-8551, Japan.
概括
在COVID-19严重免疫功能低下的患者中,联合抗病毒疗法在初始治疗失败后的成功率高于单一疗法. 这种方法可能有利于治疗持久性感染.
科学领域:
- 传染性疾病
- 免疫学
- 药理学
背景情况:
- 2019年新冠病毒病 (COVID-19) 主要使用抗病毒药物治疗.
- 严重免疫功能受损的患者可能面临持续的疾病或复发尽管抗病毒治疗,需要优化管理策略.
- 在这种患者群体中,传统单一治疗与联合抗病毒治疗的疗效尚不清楚.
研究的目的:
- 评估与综合抗病毒疗法相比,常规单一疗法的有效性在COVID-19严重免疫功能低下的患者中.
- 在初始治疗失败后,评估第二次和随后的治疗疗程的治疗成功率.
主要方法:
- 一个单一中心的回顾性队列研究包括严重免疫功能低下的COVID-19患者,这些患者对初始治疗没有反应.
- 对传统单疗法和联合疗法 (≥2种抗病毒药物,连续或并发) 的成功率进行了分析.
- 用一个通用的线性混合模型来确定与治疗成功相关的因素.
主要成果:
- 这项研究招募了23名患者,主要是患有血液性恶性瘤 (87. 0%) 和接受B细胞消耗疗法 (69. 6%).
- 在22个单一疗程中,整体成功率为50. 0%,在12个组合疗程中为91. 7%.
- 组合治疗与治疗成功有显著的关联 (p=0. 036),第二疗程成功率为100%,单一疗程成功率为56. 3%.
结论:
- 在初始治疗失败后,常规抗病毒单一治疗的失败率在严重免疫性低下的COVID-19患者中约为50%.
- 在这种具有挑战性的患者群体中,抗病毒联合治疗的临床成功率很高.
- 组合疗法在严重免疫性损害的个体中代表了对抗性COVID-19的潜在有价值策略.
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