Rothuizen Laura E, Livio Françoise, Buclin Thierry
Service de pharmacologie clinique, Département des laboratoires, CHUV, 1011 Lausanne.
Rev Med Suisse. 2020 Apr 29;16(N° 691-2):852-854.
The safety of NSAIDs, corticosteroids and renin-angiotensin inhibitors in COVID-19 is challenged. NSAIDs may interfere with the defense process against viral infection and are best avoided. Systemic corticosteroids have not shown benefit in viral infection, including other coronavirus; thus they should be avoided, unless prescribed for another indication. The benefit-risk ratio is however clearly in favor of continuing inhaled corticosteroids in patients with asthma or COPD. ACE inhibitors and sartans upregulate the expression of angiotensin-converting enzyme 2 (ACE2), the pulmonary receptor for SARS-CoV-2. Any possible clinical impact of these treatments on COVID-19 infection remains to be clarified; in the meantime, they should be continued.
非甾体抗炎药（NSAIDs）、皮质类固醇和肾素-血管紧张素抑制剂在新型冠状病毒肺炎（COVID-19）中的安全性受到质疑。NSAIDs可能会干扰针对病毒感染的防御过程，最好避免使用。全身用皮质类固醇在包括其他冠状病毒在内的病毒感染中未显示出益处；因此，除非有其他适应症，否则应避免使用。然而，对于哮喘或慢性阻塞性肺疾病（COPD）患者，继续使用吸入性皮质类固醇的获益风险比显然是有利的。血管紧张素转换酶抑制剂（ACE抑制剂）和沙坦类药物会上调血管紧张素转换酶2（ACE2）的表达，而ACE2是严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的肺部受体。这些治疗方法对COVID-19感染的任何可能临床影响仍有待阐明；与此同时，应继续使用这些药物。
