Immunotoxicology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, United Kingdom.
Department of Surgery, University of Cambridge, NIHR Cambridge Biomedical, Cambridge, United Kingdom.
Front Immunol. 2020 Aug 11;11:1991. doi: 10.3389/fimmu.2020.01991. eCollection 2020.
Evidence from the global outbreak of SARS-CoV-2 has clearly demonstrated that individuals with pre-existing comorbidities are at a much greater risk of dying from COVID-19. This is of great concern for individuals living with these conditions, and a major challenge for global healthcare systems and biomedical research. Not all comorbidities confer the same risk, however, many affect the function of the immune system, which in turn directly impacts the response to COVID-19. Furthermore, the myriad of drugs prescribed for these comorbidities can also influence the progression of COVID-19 and limit additional treatment options available for COVID-19. Here, we review immune dysfunction in response to SARS-CoV-2 infection and the impact of pre-existing comorbidities on the development of COVID-19. We explore how underlying disease etiologies and common therapies used to treat these conditions exacerbate COVID-19 progression. Moreover, we discuss the long-term challenges associated with the use of both novel and repurposed therapies for the treatment of COVID-19 in patients with pre-existing comorbidities.
从全球范围内爆发的 SARS-CoV-2 疫情中可以清楚地看到，患有合并症的个体死于 COVID-19 的风险要大得多。这对患有这些疾病的个体来说是一个重大的担忧，也是对全球医疗保健系统和生物医学研究的一个重大挑战。然而，并非所有合并症都具有相同的风险，许多合并症会影响免疫系统的功能，而免疫系统的功能又会直接影响对 COVID-19 的反应。此外，为治疗这些合并症而开的药物也会影响 COVID-19 的进展，并限制 COVID-19 的其他治疗选择。在这里，我们回顾了针对 SARS-CoV-2 感染的免疫功能障碍以及先前存在的合并症对 COVID-19 发展的影响。我们探讨了潜在疾病病因和用于治疗这些疾病的常见疗法如何加剧 COVID-19 的进展。此外，我们还讨论了在患有先前存在的合并症的患者中，使用新型和重新定位的疗法治疗 COVID-19 所带来的长期挑战。
