Department of Immunology, Semnan University of Medical Sciences, Semnan, Iran.
Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran.
J Cell Physiol. 2020 Dec;235(12):9133-9142. doi: 10.1002/jcp.29785. Epub 2020 May 11.
In late December 2019 in Wuhan, China, several patients with viral pneumonia were identified as 2019 novel coronavirus (2019-nCoV). So far, there are no specific treatments for patients with coronavirus disease-19 (COVID-19), and the treatments available today are based on previous experience with similar viruses such as severe acute respiratory syndrome-related coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and Influenza virus. In this article, we have tried to reach a therapeutic window of drugs available to patients with COVID-19. Cathepsin L is required for entry of the 2019-nCoV virus into the cell as target teicoplanin inhibits virus replication. Angiotensin-converting-enzyme 2 (ACE2) in soluble form as a recombinant protein can prevent the spread of coronavirus by restricting binding and entry. In patients with COVID-19, hydroxychloroquine decreases the inflammatory response and cytokine storm, but overdose causes toxicity and mortality. Neuraminidase inhibitors such as oseltamivir, peramivir, and zanamivir are invalid for 2019-nCoV and are not recommended for treatment but protease inhibitors such as lopinavir/ritonavir (LPV/r) inhibit the progression of MERS-CoV disease and can be useful for patients of COVID-19 and, in combination with Arbidol, has a direct antiviral effect on early replication of SARS-CoV. Ribavirin reduces hemoglobin concentrations in respiratory patients, and remdesivir improves respiratory symptoms. Use of ribavirin in combination with LPV/r in patients with SARS-CoV reduces acute respiratory distress syndrome and mortality, which has a significant protective effect with the addition of corticosteroids. Favipiravir increases clinical recovery and reduces respiratory problems and has a stronger antiviral effect than LPV/r. currently, appropriate treatment for patients with COVID-19 is an ACE2 inhibitor and a clinical problem reducing agent such as favipiravir in addition to hydroxychloroquine and corticosteroids.
2019 年 12 月下旬,在中国武汉,发现了几例病毒性肺炎患者,这些患者被确认为 2019 新型冠状病毒(2019-nCoV)。迄今为止,针对冠状病毒病-19(COVID-19)患者,尚无特定的治疗方法,目前可用的治疗方法是基于以前对类似病毒(如严重急性呼吸综合征相关冠状病毒(SARS-CoV)、中东呼吸综合征冠状病毒(MERS-CoV)和流感病毒)的经验。在本文中,我们试图为 COVID-19 患者找到可用药物的治疗窗口。组织蛋白酶 L 是 2019-nCoV 病毒进入细胞所必需的,靶替考拉宁可抑制病毒复制。以可溶性形式存在的血管紧张素转换酶 2(ACE2)作为重组蛋白,可通过限制结合和进入来阻止冠状病毒的传播。在 COVID-19 患者中,羟氯喹可降低炎症反应和细胞因子风暴,但过量会引起毒性和死亡率。神经氨酸酶抑制剂,如奥司他韦、帕拉米韦和扎那米韦,对 2019-nCoV 无效,不建议用于治疗,但蛋白酶抑制剂,如洛匹那韦/利托那韦(LPV/r),可抑制 MERS-CoV 疾病的进展,对 COVID-19 患者可能有用,与阿比多尔联合使用时,对 SARS-CoV 的早期复制具有直接抗病毒作用。利巴韦林会降低呼吸患者的血红蛋白浓度,瑞德西韦可改善呼吸症状。在 SARS-CoV 患者中,利巴韦林联合 LPV/r 的使用可降低急性呼吸窘迫综合征和死亡率,联合使用皮质类固醇具有显著的保护作用。法匹拉韦可增加临床康复率,减少呼吸问题,并且抗病毒作用强于 LPV/r。目前,针对 COVID-19 患者的适当治疗方法是除羟氯喹和皮质类固醇外,还使用 ACE2 抑制剂和临床问题减少剂,如法匹拉韦。