Rodriguez-Guerra Miguel, Jadhav Preeti, Vittorio Timothy J
Department of Internal Medicine, BronxCare Hospital Center, Bronx, NY, USA.
Division of Cardiology, BronxCare Hospital Center, Bronx, NY, USA.
Drugs Context. 2021 Jan 29;10. doi: 10.7573/dic.2020-10-3. eCollection 2021.
The world has faced the most challenging pandemic of the modern era, that of severe acute respiratory syndrome coronavirus 2 infection, causing coronavirus disease and affecting over 35 million people globally. The wide range of clinical manifestations associated with this viral disease is thought to be related to the overexpression of inflammatory markers. Due to a dysregulated host response, the most severe form involves multi-organ failure and thromboembolic complications. Immunomodulatory therapies may help prevent its progression and anticoagulation has been shown to reduce the risk of thrombotic complications. As this is a new entity for the medical world, there are no known therapeutic options nor has the prevention of complications been established. Anti-inflammatory agents, antimicrobial therapy, and vitamin supplements are short of clear benefits, but there is limited data to review. Other agents, such as convalescent plasma, eculizumab, immunoglobulins, neutralizing IgG1 monoclonal antibodies, remdesivir, steroids, and tocilizumab, have shown a possible impact on inpatient length of stay and mortality rate. This review aims to assess the efficacy and safety of these available therapies in light of current evidence. We compare these treatment options based on their impact on symptom management, inpatient length of stay, and overall morbidity and mortality.
全球面临着现代史上最具挑战性的大流行疾病，即严重急性呼吸综合征冠状病毒2感染，引发了冠状病毒病，全球感染人数超过3500万。这种病毒性疾病的广泛临床表现被认为与炎症标志物的过度表达有关。由于宿主反应失调，最严重的形式包括多器官衰竭和血栓栓塞并发症。免疫调节疗法可能有助于预防其进展，并且抗凝治疗已被证明可降低血栓形成并发症的风险。由于这对医学界来说是一个新事物，目前尚无已知的治疗选择，并发症的预防也尚未确立。抗炎药、抗菌治疗和维生素补充剂缺乏明确的益处，但可供审查的数据有限。其他药物，如康复期血浆、依库珠单抗、免疫球蛋白、中和性IgG1单克隆抗体、瑞德西韦、类固醇和托珠单抗，已显示出对住院时间和死亡率可能产生影响。本综述旨在根据现有证据评估这些可用疗法的疗效和安全性。我们根据这些治疗方案对症状管理、住院时间以及总体发病率和死亡率的影响进行比较。
