Panovska-Stavridis Irina, Ridova Nevenka, Stojanoska Tatjana, Demiri Ilir, Stevanovic Milena, Stojanovska Simona, Ristevska Tara, Dimkovski Aleksandar, Filipce Venko, Dimovski Aleksandar, Grozdanova Aleksandra
University Clinic of Hematology, Medical Faculty, University Ss. Cyril and Methodius, Skopje, Republic of North Macedonia.
University Clinic of Infection Diseases and Febrile Conditions, Faculty of Medicine, University Ss. Cyril and Methodius, Skopje, Republic of North Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Apr 23;42(1):5-18. doi: 10.2478/prilozi-2021-0001.
The outbreak of the COVID-19 pandemic has generated the largest global health crisis of the 21st century, evolving into accelerating socioeconomic disruption. In spite of all rapidly and widely emerging scientific data on epidemiology, diagnosis, prevention and treatment of the COVID-19 disease, severe acute respiratory coronavirus 2 (SARS-CoV-2) is continuing to propagate in lack of definitive and specific therapeutic agents. Current therapeutic strategies are mainly focused on viral inhibition by antiviral drugs and hampering the exuberant immune response of the host by immunomodulatory drugs. In this review, we have studied the reports of the largest clinical trials intended to COVID-19 treatment published during the first year of the pandemics. In general, these results concentrate on seven therapeutic options: remdesivir, chloroguine/hydroxychloroquine, lopinavir-ritonavir combination, corticosteroids, tocilizumab, convalescent plasma and monoclonal antibodies. In line with the reviewed data, as of January 2021, most of the evidence support the use of remdesivir in hospitalized patients with moderate and severe forms of the disease and provide reliable data on the substantial beneficial effect of corticosteroids in patients requiring supplemental oxygen. Moreover, preliminary RECOVERY trial results have demonstrated the efficacy of tociluzumab in the treatment of critically ill patients. The reports presenting the outcomes of the other immune-based therapies under investigation are enthusiastically awaited.
新型冠状病毒肺炎（COVID-19）大流行的爆发引发了21世纪最大的全球健康危机，并演变成加速的社会经济混乱。尽管关于COVID-19疾病的流行病学、诊断、预防和治疗的科学数据迅速广泛涌现，但严重急性呼吸综合征冠状病毒2（SARS-CoV-2）仍在继续传播，缺乏明确和特异性的治疗药物。目前的治疗策略主要集中在通过抗病毒药物抑制病毒以及通过免疫调节药物抑制宿主过度的免疫反应。在本综述中，我们研究了在大流行的第一年期间发表的旨在治疗COVID-19的最大规模临床试验的报告。总体而言，这些结果集中在七种治疗选择上：瑞德西韦、氯喹/羟氯喹、洛匹那韦-利托那韦组合、皮质类固醇、托珠单抗、康复期血浆和单克隆抗体。根据所审查的数据，截至2021年1月，大多数证据支持在患有中度和重度疾病的住院患者中使用瑞德西韦，并提供了关于皮质类固醇对需要补充氧气的患者有显著有益效果的可靠数据。此外，RECOVERY试验的初步结果证明了托珠单抗在治疗重症患者方面的疗效。人们热切期待着有关正在研究的其他基于免疫的疗法结果的报告。
