Menzella Francesco, Matucci Andrea, Vultaggio Alessandra, Barbieri Chiara, Biava Mirella, Scelfo Chiara, Fontana Matteo, Facciolongo Nicola Cosimo
Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia.
Immunoallergology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence.
Multidiscip Respir Med. 2020 Nov 9;15(1):708. doi: 10.4081/mrm.2020.708. eCollection 2020 Jan 28.
The novel coronavirus called "Severe Acute Respiratory Syndrome Coronavirus 2" (SARS-CoV-2) caused an outbreak in December 2019, starting from the Chinese city of Wuhan, in the Hubei province, and rapidly spreading to the rest of the world. Consequently, the World Health Organization (WHO) declared that the coronavirus disease of 2019 (COVID-19) can be characterized as a pandemic. During COVID-19 several immunological alterations have been observed: in plasma of severe patients, inflammatory cytokines are at a much higher concentration ("cytokine storm"). These aspects are associated with pulmonary inflammation and parenchymal infiltrates with an extensive lung tissue damage in COVID-19 patients. To date, clinical evidence and guidelines based on reliable data and randomized clinical trials (RCTs) for the treatment of COVID-19 are lacking. In the absence of definitive management protocols, many treatments are currently being evaluated worldwide. Some of these options were soon abandoned due to ineffectiveness, while others showed promising results. As for ventilatory strategies, at the moment there are still no consistent data published about the different approaches and how they may influence disease progression. What will probably represent the real solution to this pandemic is the identification of a safe and effective vaccine, for which enormous efforts and investments are being put in place. This review will summarize the state-of-the-art of COVID-19 current treatment options and those potentially available in the future, as well as high flow oxygen therapy and non-invasive mechanical ventilation approaches.
一种名为“严重急性呼吸综合征冠状病毒2”（SARS-CoV-2）的新型冠状病毒于2019年12月引发疫情，最初始于中国湖北省武汉市，并迅速蔓延至世界其他地区。因此，世界卫生组织（WHO）宣布2019冠状病毒病（COVID-19）可被界定为大流行病。在COVID-19疫情期间，人们观察到了一些免疫方面的改变：在重症患者的血浆中，炎性细胞因子的浓度要高得多（“细胞因子风暴”）。这些情况与COVID-19患者的肺部炎症、实质浸润以及广泛的肺组织损伤有关。迄今为止，缺乏基于可靠数据和随机临床试验（RCT）的COVID-19治疗的临床证据和指南。在没有明确的管理方案的情况下，目前全球正在评估多种治疗方法。其中一些方法由于无效很快被放弃，而其他一些则显示出有希望的结果。至于通气策略，目前仍没有关于不同方法及其对疾病进展可能产生何种影响的一致数据发表。可能代表这场大流行病真正解决方案的是找到一种安全有效的疫苗，目前正在为此付出巨大努力并投入大量资金。本综述将总结COVID-19当前治疗方案以及未来可能可用方案的最新情况，以及高流量氧疗和无创机械通气方法。
