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药物营养在新型冠状病毒肺炎临床管理中的应用:缺乏循证研究但有个性化处方线索

Pharmaconutrition in the Clinical Management of COVID-19: A Lack of Evidence-Based Research But Clues to Personalized Prescription.

作者信息

Santos Heitor O, Tinsley Grant M, da Silva Guilherme A R, Bueno Allain A

机构信息

School of Medicine, Federal University of Uberlandia (UFU), Uberlandia 38408-100, Brazil.

Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA.

出版信息

J Pers Med. 2020 Sep 25;10(4):145. doi: 10.3390/jpm10040145.

Abstract

A scientific interest has emerged to identify pharmaceutical and nutritional strategies in the clinical management of coronavirus disease 2019 (COVID-19). The purpose of this narrative review is to critically assess and discuss pharmaconutrition strategies that, secondary to accepted treatment methods, could be candidates in the current context of COVID-19. Oral medicinal doses of vitamin C (1-3 g/d) and zinc (80 mg/d elemental zinc) could be promising at the first signs and symptoms of COVID-19 as well as for general colds. In critical care situations requiring parenteral nutrition, vitamin C (3-10 g/d) and glutamine (0.3-0.5 g/kg/d) administration could be considered, whereas vitamin D3 administration (100,000 IU administered intramuscularly as a one-time dose) could possess benefits for patients with severe deficiency. Considering the presence of n-3 polyunsaturated fatty acids and arginine in immune-enhancing diets, their co-administration may also occur in clinical conditions where these formulations are recommended. However, despite the use of the aforementioned strategies in prior contexts, there is currently no evidence of the utility of any nutritional strategies in the management of SARS-CoV-2 infection and COVID-19. Nevertheless, ongoing and future clinical research is imperative to determine if any pharmaconutrition strategies can halt the progression of COVID-19.

摘要

在2019冠状病毒病(COVID-19)的临床管理中,人们对确定药物和营养策略产生了科学兴趣。本叙述性综述的目的是批判性地评估和讨论药物营养策略,这些策略作为公认治疗方法的辅助手段,在当前COVID-19背景下可能成为候选方案。口服药用剂量的维生素C(1-3克/天)和锌(80毫克/天元素锌)在COVID-19的最初症状以及普通感冒时可能很有前景。在需要肠外营养的重症监护情况下,可以考虑给予维生素C(3-10克/天)和谷氨酰胺(0.3-0.5克/千克/天),而给予维生素D3(一次性肌肉注射100,000国际单位)可能对严重缺乏的患者有益。考虑到免疫增强饮食中存在n-3多不饱和脂肪酸和精氨酸,在推荐这些制剂的临床情况下,也可能同时使用它们。然而,尽管在之前的情况下使用了上述策略,但目前尚无证据表明任何营养策略在管理严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染和COVID-19方面有用。尽管如此,进行中的和未来的临床研究对于确定任何药物营养策略是否能够阻止COVID-19的进展至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1226/7712662/8631a407b9fb/jpm-10-00145-g001.jpg

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