Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade, 11221, Belgrade, Serbia.
Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade, 11221, Belgrade, Serbia.
Food Chem Toxicol. 2020 Oct;144:111639. doi: 10.1016/j.fct.2020.111639. Epub 2020 Jul 21.
On 11 March 2020, the pandemic of the new coronavirus was declared by the World Health Organization. At the moment, there are no new registered medicines that can effectively treat the coronavirus infection. However, a number of ongoing clinical trials are investigating the efficacy and safety of the medicines which have already been registered and used for the treatment of other diseases, in the treatment of the coronavirus infection. The proposed combinations of these medicines could potentially present a safety risk, since most of these medicines have the potential to cause numerous side or toxic effects, even when used in monotherapy. Thus, the aim of this study was to review and evaluate the literature data on the toxicity of the selected individual drugs (ritonavir, lopinavir, remdesivir, chloroquine, and umifenovir) and the available clinical data concerning the possible adverse effects of the selected drug combinations (lopinavir/ritonavir + umifenovir, lopinavir/ritonavir + interferon β, chloroquine + remdesivir, and chloroquine + azithromycin). The most often reported toxic effects of these medicines such as hepatotoxicity, retinal damage, nephrotoxicity, and cardiotoxicity, together with the fact that the health status of the patients with COVID-19 disease is often complicated by co-existing illnesses and therapy implicate that the decision on the therapeutic strategy should be made with caution.
2020 年 3 月 11 日，世界卫生组织宣布了新的冠状病毒大流行。目前，尚无新注册的药物可以有效治疗冠状病毒感染。然而，一些正在进行的临床试验正在研究已经注册并用于治疗其他疾病的药物在治疗冠状病毒感染方面的疗效和安全性。这些药物的联合应用可能存在安全风险，因为大多数这些药物都有可能引起许多副作用或毒性作用，即使在单独使用时也是如此。因此，本研究的目的是回顾和评估关于选定的单一药物（利托那韦、洛匹那韦、瑞德西韦、氯喹和乌米福韦）的毒性的文献数据，以及关于选定的药物联合应用（洛匹那韦/利托那韦+乌米福韦、洛匹那韦/利托那韦+干扰素β、氯喹+瑞德西韦和氯喹+阿奇霉素）可能产生的不良反应的现有临床数据。这些药物最常报道的毒性作用包括肝毒性、视网膜损伤、肾毒性和心脏毒性，再加上 COVID-19 疾病患者的健康状况通常因合并疾病和治疗而变得复杂，这意味着应谨慎做出治疗策略的决定。
