Department of Pharmacology & Therapeutics, Seth GSMC & KEM Hospital, Mumbai, 400012, India.
Department of Pharmacology & Therapeutics, Seth GSMC & KEM Hospital, Mumbai, 400012, India.
Biomed Pharmacother. 2020 Aug;128:110267. doi: 10.1016/j.biopha.2020.110267. Epub 2020 May 14.
Novel Corona-virus Disease 2019 (nCOVID 19) is caused by a novel virulent corona virus and leads to potentially fatal virulent pneumonia and severe respiratory distress syndrome. It was initially declared as public health emergency if international concern by WHO followed by Pandemic on 12th March 2020. As of 10th April 2020, more than 1.5 million people are affected globally with around 95,000 deaths. Vaccines for this deadly virus are currently under development and many drugs used for other indications have been repurposed and investigated for prophylaxis and treatment of COVID 19. As per SOLIDARITY trial by WHO, some of the most promising candidates include chloroquine phosphate and hydroxychloroquine which are anti-malarial medications, Remdesivir, Lopinavir-Ritonavir combination with or without interferon which are anti-HIV drugs and convalescent plasma therapy. The current evidence of efficacy and ongoing research has been elaborated in the article. Besides, there has been evidence regarding inflammatory pathogenesis of this virus leading to cytokine storm in susceptible individuals. Thus, anti-proinflammatory cytokine drugs like Anakinra and Tocilizumab are undergoing multiple trials and some results are encouraging. Similarly, use of anti-inflammatory cytokines like IL-37 and IL-38 is hypothesised to be useful and is under research. The situation is still evolving and hence there is yet no definitive therapy but to conclude the use of repurposed medications can be a boon till a definitive therapy and vaccines are developed.
新型冠状病毒病 2019（nCOVID-19）由一种新型烈性冠状病毒引起，可导致潜在致命性烈性肺炎和严重呼吸窘迫综合征。最初，世界卫生组织宣布其为国际关注的公共卫生紧急事件，随后于 2020 年 3 月 12 日宣布其为大流行。截至 2020 年 4 月 10 日，全球已有超过 150 万人受到影响，约有 9.5 万人死亡。目前正在开发针对这种致命病毒的疫苗，许多用于其他适应症的药物已被重新用于预防和治疗 COVID-19。根据世界卫生组织的 SOLIDARITY 试验，一些最有希望的候选药物包括磷酸氯喹和羟氯喹，这两种药物都是抗疟药物；瑞德西韦、洛匹那韦/利托那韦联合或不联合干扰素，这是抗 HIV 药物；恢复期血浆疗法。本文详细阐述了目前关于这些药物疗效的证据和正在进行的研究。此外，已经有证据表明这种病毒的炎症发病机制导致易感个体发生细胞因子风暴。因此，阿那白滞素和托珠单抗等抗炎细胞因子药物正在进行多项试验，一些结果令人鼓舞。同样，使用白细胞介素 37（IL-37）和白细胞介素 38（IL-38）等抗炎细胞因子也被假设是有用的，并正在研究中。目前情况仍在不断发展，因此，虽然尚未确定有效的治疗方法，但可以得出结论，在开发出明确的治疗方法和疫苗之前，重新使用这些药物可能是一种福音。
