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预防、减轻和治疗 COVID-19 的药物和非药物措施。

Pharmacological and non-pharmacological efforts at prevention, mitigation, and treatment for COVID-19.

机构信息

Pharmaceutical Sciences, University of the Sciences in Philadelphia, Philadelphia, PA, USA.

Eurofins Lancaster Laboratories Inc, Malvern, PA, USA.

出版信息

J Drug Target. 2020 Aug-Sep;28(7-8):742-754. doi: 10.1080/1061186X.2020.1793990. Epub 2020 Jul 16.

Abstract

A global outbreak of the SARS-CoV-2 virus has infected millions of people over a short period of time. The communicability and increased mortality from the SARS-CoV-2 infection mandated the WHO to declare COVID-19 a worldwide pandemic. The virus outbreak has spread when there are no approved vaccines, treatments, or prophylactic therapies available. Researchers from all over the world have prioritised development of vaccines and antivirals. Several vaccine projects have seen successes in preclinical, phase I, and phase II clinical trials using recombinant DNA, mRNA, live attenuated virus, S-protein subunits, virus like particles, and viral vectors. Initial findings from antivirals such as remdesivir, favipiravir, danoprevir or lopinavir with ritonavir are presented. Immunomodulatory molecules such as sarilumab, tocilizumab, janus kinase inhibitors, and hyperimmune convalescent plasma have mixed outcomes from initial clinical findings; however, pending randomised controlled trials will assist national health institutions to make treatment recommendations for COVID-19. Where compassionate use of remdesivir has shown some benefits, therapies such as hydroxychloroquine have proven harmful due to their toxicities. This review discusses pharmacological interventions at play and evidence-based successes and limitations of non-pharmacological therapies such as social distancing, personal protective equipment, and ventilator support associated with the prevention and treatment of COVID-19.

摘要

一种新型冠状病毒在短时间内感染了数百万人,引发了全球疫情。由于这种病毒具有较强的传染性和较高的致死率,世界卫生组织(WHO)宣布将其引发的疾病正式命名为 COVID-19 大流行。由于目前尚无批准的疫苗、治疗方法或预防疗法,病毒的传播仍在继续。来自世界各地的研究人员将疫苗和抗病毒药物的研发放在了首位。在使用重组 DNA、mRNA、减毒活病毒、S 蛋白亚单位、病毒样颗粒和病毒载体的临床前、I 期和 II 期临床试验中,多个疫苗项目取得了成功。瑞德西韦、法匹拉韦、达诺普韦或洛匹那韦与利托那韦等抗病毒药物的初步发现结果也已公布。免疫调节分子,如 sarilumab、托珠单抗、Janus 激酶抑制剂和高免疫恢复期血浆,其初步临床发现结果喜忧参半;但是,正在进行的随机对照试验将有助于国家卫生机构为 COVID-19 治疗提出建议。瑞德西韦的同情用药显示出一些益处,而羟氯喹等疗法由于其毒性而被证明是有害的。本文综述了正在使用的药理学干预措施以及非药物治疗方法的循证成功和局限性,如社会隔离、个人防护设备和呼吸机支持,这些方法与 COVID-19 的预防和治疗有关。

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