Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece.
Division of Brain Sciences, Imperial College London, London, UK.
Clin Exp Med. 2021 May;21(2):167-179. doi: 10.1007/s10238-020-00671-y. Epub 2020 Oct 30.
The new type of coronavirus (COVID-19), SARS-CoV-2 originated from Wuhan, China and has led to a worldwide pandemic. COVID-19 is a novel emerging infectious disease caused by SARS-CoV-2 characterized as atypical pneumonia. As of July 1, 2020, more than 10 million people worldwide had been infected with SARS-CoV-2. The typical manifestations of COVID-19 include fever, sore throat, fatigue, cough, and dyspnoea combined with recent exposure. Most of the patients with COVID-19 have mild or moderate disease, however up to 5-10% present with severe and even life-threatening disease course. The mortality rates are approximately 2%. Therefore, there is an urgent need for effective and specific antiviral treatment. Currently, supportive care measures such as ventilation oxygenation and fluid management remain the standard of care. Several clinical trials are currently trying to identify the most potent drug or combination against the disease, and it is strongly recommended to enroll patients into ongoing trials. Antivirals can be proven as safe and effective only in the context of randomized clinical trials. Currently several agents such as chloroquine, hydroxychloroquine, favipiravir, monoclonal antibodies, antisense RNA, corticosteroids, convalescent plasma and vaccines are being evaluated. The large numbers of therapeutic interventions aim to define the most efficacious regimen. The aim of this article is to describe the treatment strategies that have been used for COVID-19 patients and review all the available literature.
新型冠状病毒(COVID-19),SARS-CoV-2 起源于中国武汉,已导致全球大流行。COVID-19 是一种由 SARS-CoV-2 引起的新型突发传染病,表现为非典型性肺炎。截至 2020 年 7 月 1 日,全球已有超过 1000 万人感染 SARS-CoV-2。COVID-19 的典型表现包括发热、咽痛、乏力、咳嗽和呼吸困难,并伴有近期暴露史。大多数 COVID-19 患者为轻症或中度,然而高达 5-10%的患者病情严重,甚至危及生命。死亡率约为 2%。因此,急需有效的、特异的抗病毒治疗。目前,通气氧疗和液体管理等支持性治疗措施仍是标准治疗方法。目前正在进行多项临床试验,以确定针对该疾病最有效的药物或联合用药,强烈建议患者参加正在进行的临床试验。只有在随机临床试验中,才能证明抗病毒药物的安全性和有效性。目前正在评估氯喹、羟氯喹、法匹拉韦、单克隆抗体、反义 RNA、皮质类固醇、恢复期血浆和疫苗等几种药物。大量的治疗干预措施旨在确定最有效的方案。本文旨在描述已用于 COVID-19 患者的治疗策略,并回顾所有现有文献。