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新型冠状病毒肺炎的经验性治疗与预防

Empirical Treatment and Prevention of COVID-19.

作者信息

Shin Hyoung Shik

机构信息

Infectious Diseases Specialist, Korean Society of Zoonoses, Seoul, Korea.

出版信息

Infect Chemother. 2020 Jun;52(2):142-153. doi: 10.3947/ic.2020.52.2.142. Epub 2020 Jun 1.

Abstract

The rapid spread of severe acute respiratory coronavirus syndrome 2 (SARS-CoV-2) in the population and throughout the cells within our body has been developing. Another major cycle of coronavirus disease 2019 (COVID-19), which is expected in the coming fall, could be even more severe than the current one. Therefore, effective countermeasures should be developed based on the already obtained clinical and research information about SARS-CoV-2. The aim of this review was to summarize the data on the empirical treatment of COVID-19 acquired during this SARS-CoV-2 infection cycle; this would aid the establishment of an appropriate healthcare policy to meet the challenges in the future. The infectious disease caused by SARS-CoV-2 is characterized by common cold along with hypersensitivity reaction. Thus, in addition to treating common cold, it is essential to minimize the exposure of cells to the virus and to mitigate the uncontrolled immune response. A proper combination of antiviral agents, immune modulators such as prednisolone, and anticoagulants such as heparin and anti-C5a antagonists could be employed to minimize lung damage and prevent systemic involvements. Finally, strategies to achieve population immunity against SARS-CoV-2 should be developed through understanding of the interaction between the immune system and the virus.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在人群中以及在我们体内的细胞间迅速传播的情况一直在发展。预计在即将到来的秋季出现的2019冠状病毒病(COVID-19)的另一个主要流行周期可能比当前的更加严重。因此,应根据已获得的关于SARS-CoV-2的临床和研究信息制定有效的应对措施。本综述的目的是总结在这个SARS-CoV-2感染周期中获得的关于COVID-19经验性治疗的数据;这将有助于制定适当的医疗政策以应对未来的挑战。由SARS-CoV-2引起的传染病的特征是伴有超敏反应的普通感冒。因此,除了治疗普通感冒外,尽量减少细胞与病毒的接触并减轻不受控制的免疫反应至关重要。可以采用抗病毒药物、免疫调节剂(如泼尼松龙)以及抗凝剂(如肝素和抗C5a拮抗剂)的适当组合,以尽量减少肺部损伤并防止全身受累。最后,应通过了解免疫系统与病毒之间的相互作用来制定实现针对SARS-CoV-2的群体免疫的策略。

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