State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, China.
Department of Pharmacy, Affiliated to Dongtai Hospital of Nantong University, Dongtai, China.
Ann Palliat Med. 2021 Apr;10(4):4777-4798. doi: 10.21037/apm-20-1971. Epub 2021 Apr 9.
Coronavirus disease 2019 (COVID-19) has become a global pandemic affecting more than 200 countries with 87 million patients worldwide as of January 7, 2021. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) replicates in a large amount and reaches high-titer levels in a short time after the infection. COVID-19 caused by SARS-CoV-2 shows clinical symptoms mainly including fever, fatigue, dry cough, and dyspnea. In more severe COVID-19 patients, viral pneumonia characterized by bilateral ground glass or patchy opacity, may lead to acute respiratory distress syndrome (ARDS), cytokine storm, multi-organ damage, and even death. Unfortunately, there is no effective therapy for COVID-19 until now. Magnesium isoglycyrrhizinate (MgIG), a magnesium salt of 18-α glycyrrhizic acid stereoisomer, belongs to the fourth generation of glycyrrhizic acid preparation. MgIG has various pharmacological activities including anti-inflammation, anti-oxidation, anti-virus, and immunoregulation, showing the protection against the injury of the vital organs (such as kidney, heart, and lung). Clinically, MgIG injection is usually used as a hepatoprotective agent to treat liver diseases. This narrative review summarizes the research and application of MgIG, and provides the evidence supporting the recommended MgIG as supportive therapy in the "Management Standard for Mild and Common Patients of Coronavirus Disease 2019 (COVID-19) (Second Edition)", which is jointly issued by National Health Commission of People's Republic of China and National Administration of Traditional Chinese Medicine.
截至 2021 年 1 月 7 日，2019 年冠状病毒病（COVID-19）已在全球 200 多个国家蔓延，影响超过 8700 万人。严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）在感染后大量复制，短时间内达到高滴度水平。由 SARS-CoV-2 引起的 COVID-19 主要表现为发热、乏力、干咳、呼吸困难等临床症状。在更严重的 COVID-19 患者中，病毒肺炎的特征为双肺磨玻璃影或斑片状阴影，可能导致急性呼吸窘迫综合征（ARDS）、细胞因子风暴、多器官损伤，甚至死亡。不幸的是，到目前为止，COVID-19 还没有有效的治疗方法。异甘草酸镁（MgIG）是 18-α 甘草酸立体异构体的镁盐，属于第四代甘草酸制剂。MgIG 具有多种药理作用，包括抗炎、抗氧化、抗病毒和免疫调节，对重要器官（如肾脏、心脏和肺部）的损伤具有保护作用。临床上，MgIG 注射液通常用作肝保护剂治疗肝病。本综述总结了 MgIG 的研究和应用，为国家卫生健康委员会和国家中医药管理局联合发布的《新型冠状病毒肺炎轻型和普通型患者的管理规范（第二版）》中推荐 MgIG 作为支持治疗提供了依据。
