Medical student in the Faculty of Medicine at the University of British Columbia in Vancouver.
Assistant Professor in the Leslie Dan Faculty of Pharmacy at the University of Toronto in Ontario.
Can Fam Physician. 2021 Mar;67(3):171-179. doi: 10.46747/cfp.6703171.
To keep health care providers, in response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, informed about the medications that have been proposed to treat the disease and the evidence supporting their use.
A narrative review of medications most widely used to treat COVID-19 was conducted, outlining the best available evidence for each pharmacologic treatment to date. Searches were performed in PubMed, EMBASE, and MEDLINE using key words and , as well as related terms. Relevant research studies conducted in human populations and cases specific to patients with COVID-19 were included, as were relevant hand-searched papers and reviews. Only articles in English and Chinese were included.
While current management of patients with COVID-19 largely involves supportive care, without a widely available vaccine, practitioners have also resorted to repurposing medications used for other indications. This has caused considerable controversy, as many of these treatments have limited clinical evidence supporting their use and therefore pose implications for patient safety, drug access, and public health. For instance, medications such as hydroxychloroquine and chloroquine, lopinavir-ritonavir, nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers gained widespread media attention owing to hype, misinformation, or misinterpretation of research evidence.
Given the severity of the pandemic and the potential broad effects of implementing safe and effective treatment, this article provides a narrative review of the current evidence behind the most widely used medications to treat COVID-19 in order to enable health care practitioners to make informed decisions in the care of patients with this life-threatening disease.
使医疗保健提供者能够了解针对当前正在流行的 2019 冠状病毒病(COVID-19)提出的治疗该疾病的药物以及支持其使用的证据。
对用于治疗 COVID-19 的最广泛使用的药物进行了叙述性综述,概述了迄今为止每种药物治疗的最佳现有证据。在 PubMed、EMBASE 和 MEDLINE 中使用关键词 和 ,以及相关术语进行了搜索。纳入了在人类人群中进行的相关研究以及针对 COVID-19 患者的具体病例研究,还纳入了相关的手工搜索论文和综述。仅纳入了英文和中文的文章。
尽管目前 COVID-19 患者的管理主要涉及支持性护理,但由于尚未广泛提供疫苗,从业者也转而重新使用用于其他适应证的药物。这引起了相当大的争议,因为这些治疗方法中的许多方法的临床证据有限,因此对患者安全、药物获取和公共卫生构成了影响。例如,羟氯喹和氯喹、洛匹那韦-利托那韦、非甾体抗炎药、血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂等药物由于炒作、错误信息或对研究证据的错误解释而引起了广泛的媒体关注。
鉴于大流行的严重程度以及实施安全有效的治疗方法的潜在广泛影响,本文对用于治疗 COVID-19 的最广泛使用的药物的现有证据进行了叙述性综述,以便医疗保健从业者能够在治疗这种危及生命的疾病时做出明智的决策。