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新型冠状病毒肺炎(COVID-19)感染患者临床表现及管理中的争议问题与不断演变的概念,涉及合并疾病(高血压、糖尿病等)治疗中使用的治疗性药物及其他药物的应用

Contentious issues and evolving concepts in the clinical presentation and management of patients with COVID-19 infectionwith reference to use of therapeutic and other drugs used in Co-morbid diseases (Hypertension, diabetes etc).

作者信息

Gupta Ritesh, Misra Anoop

机构信息

Fortis CDOC Hospital, Chirag Enclave, New Delhi, India.

Fortis CDOC Hospital, Chirag Enclave, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India.

出版信息

Diabetes Metab Syndr. 2020 May-Jun;14(3):251-254. doi: 10.1016/j.dsx.2020.03.012. Epub 2020 Mar 25.

Abstract

BACKGROUND AND AIMS

Multiple issues in management of COVID have emerged, but confusion persists regarding rational interpretation. Aim of this brief review is to review these issues based on current literature.

METHODS

This is a narrative review with Pubmed and Google Scholar search till 23 March 2020. Search terms were, COVID-19, treatment of coronavirus, COVID 19 and following terms; chloroquine, hydroxychloroquine, ibuprofen, ACE-inhibitors or angiotensin receptor blockers, cardiovascular disease, diarrhoea, liver, testis and gastrointestinal disease.

RESULTS

We discuss evidence regarding role of chloroquine and hydroxychloroquine in treatment and prophylaxis, use of inhibitors of the renin angiotensin system, safety of ibuprofen, unusual clinical features like gastrointestinal symptoms and interpretation of tests for cardiac enzymes and biomarkers.

CONCLUSIONS

While our conclusions on management of COVID-19 patients with co-morbidities are based on current evidence, however, data is limited and there is immediate need for fast track research.

摘要

背景与目的

新型冠状病毒肺炎(COVID)管理中出现了多个问题,但在合理解读方面仍存在困惑。本简要综述的目的是根据当前文献对这些问题进行综述。

方法

这是一项叙述性综述,检索截至2020年3月23日的PubMed和谷歌学术。检索词为新型冠状病毒肺炎(COVID-19)、冠状病毒治疗、新型冠状病毒肺炎(COVID 19)以及以下词汇:氯喹、羟氯喹、布洛芬、血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂、心血管疾病、腹泻、肝脏、睾丸和胃肠道疾病。

结果

我们讨论了氯喹和羟氯喹在治疗和预防中的作用、肾素血管紧张素系统抑制剂的使用、布洛芬的安全性、胃肠道症状等异常临床特征以及心肌酶和生物标志物检测结果的解读等方面的证据。

结论

虽然我们对合并症COVID-19患者管理的结论基于当前证据,但数据有限,迫切需要快速开展研究。

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