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关于在疫情爆发情况下治疗新型冠状病毒(SARS-CoV-2)的新兴治疗和预防策略的循证系统评价。

An evidence-based systematic review on emerging therapeutic and preventive strategies to treat novel coronavirus (SARS-CoV-2) during an outbreak scenario.

作者信息

Gudadappanavar Anupama M, Benni Jyoti

机构信息

Department of Pharmacology, J N Medical College, KLE Academy of Higher Education and, Research (KAHER), Belagavi, Karnataka, India.

出版信息

J Basic Clin Physiol Pharmacol. 2020 Sep 14;31(6):jbcpp-2020-0113. doi: 10.1515/jbcpp-2020-0113.

Abstract

A novel coronavirus infection coronavirus disease 2019 (COVID-19) emerged from Wuhan, Hubei Province of China, in December 2019 caused by SARS-CoV-2 is believed to be originated from bats in the local wet markets. Later, animal to human and human-to-human transmission of the virus began and resulting in widespread respiratory illness worldwide to around more than 180 countries. The World Health Organization declared this disease as a pandemic in March 2020. There is no clinically approved antiviral drug or vaccine available to be used against COVID-19. Nevertheless, few broad-spectrum antiviral drugs have been studied against COVID-19 in clinical trials with clinical recovery. In the current review, we summarize the morphology and pathogenesis of COVID-19 infection. A strong rational groundwork was made keeping the focus on current development of therapeutic agents and vaccines for SARS-CoV-2. Among the proposed therapeutic regimen, hydroxychloroquine, chloroquine, remdisevir, azithromycin, toclizumab and cromostat mesylate have shown promising results, and limited benefit was seen with lopinavir-ritonavir treatment in hospitalized adult patients with severe COVID-19. Early development of SARS-CoV-2 vaccine started based on the full-length genome analysis of severe acute respiratory syndrome coronavirus. Several subunit vaccines, peptides, nucleic acids, plant-derived, recombinant vaccines are under pipeline. This article concludes and highlights ongoing advances in drug repurposing, therapeutics and vaccines to counter COVID-19, which collectively could enable efforts to halt the pandemic virus infection.

摘要

一种新型冠状病毒感染,即2019冠状病毒病(COVID-19),于2019年12月在中国湖北省武汉市出现,由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,据信起源于当地湿市场的蝙蝠。后来,该病毒开始在动物与人以及人与人之间传播,导致全球范围内超过180个国家出现广泛的呼吸道疾病。世界卫生组织于2020年3月宣布这种疾病为大流行病。目前尚无经临床批准可用于对抗COVID-19的抗病毒药物或疫苗。尽管如此,在一些针对COVID-19的临床试验中,已经对少数广谱抗病毒药物进行了研究,并取得了临床康复效果。在本综述中,我们总结了COVID-19感染的形态学和发病机制。我们以强有力的合理依据为基础,重点关注了针对SARS-CoV-2的治疗药物和疫苗的当前进展。在提出的治疗方案中,羟氯喹、氯喹、瑞德西韦、阿奇霉素、托珠单抗和甲磺司他已显示出有希望的结果,而洛匹那韦-利托那韦治疗对住院的重症COVID-19成年患者的益处有限。基于严重急性呼吸综合征冠状病毒的全长基因组分析,SARS-CoV-2疫苗的早期研发工作已经启动。几种亚单位疫苗、肽疫苗、核酸疫苗、植物源疫苗、重组疫苗正在研发中。本文总结并强调了在药物重新利用、治疗方法和疫苗方面为对抗COVID-19所取得的持续进展,这些进展共同努力可能有助于阻止这种大流行病毒的感染。

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