Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA.
Expert Opin Pharmacother. 2022 Apr;23(5):623-628. doi: 10.1080/14656566.2022.2035360. Epub 2022 Feb 1.
SARS-CoV-2, the virus that causes COVID-19, elicits a variety of host responses ranging from asymptomatic or mild illness in most people, to severe disease and critical illness in a subset of patients with systemic inflammation and hypoxemic respiratory failure.
Heterogeneous clinical presentations are often driven by disparate responses of the host immune system, with severe disease associated with aberrant interferon signaling or cytokine storm syndrome. This manuscript examines current therapeutic approaches, including the use of immunomodulators such as corticosteroids, interleukin inhibitors, kinase inhibitors, fluvoxamine, and ivermectin, and also explores the ways that these therapies and others may be used to treat COVID-19 in the future.
Modulation of the immune response has become a mainstay of treatment of COVID-19, although the optimal mechanism has not yet been defined and there is considerable controversy regarding clinical management. As time progresses, the therapeutic approach to COVID-19 will undoubtedly change, particularly as we learn more about the pathophysiology of SARS-CoV-2 infection.
导致 COVID-19 的 SARS-CoV-2 病毒会引发各种宿主反应,大多数人无症状或轻症,但在一部分有全身炎症和低氧性呼吸衰竭的患者中会出现严重疾病和危急病症。
不同的临床表现通常是由宿主免疫系统的不同反应驱动的,严重疾病与异常干扰素信号或细胞因子风暴综合征有关。本文研究了当前的治疗方法,包括使用免疫调节剂,如皮质类固醇、白细胞介素抑制剂、激酶抑制剂、氟伏沙明和伊维菌素,并探讨了这些疗法和其他疗法在未来治疗 COVID-19 的应用方式。
调节免疫反应已成为 COVID-19 治疗的主要方法,尽管尚未确定最佳机制,并且在临床管理方面存在很大争议。随着时间的推移,COVID-19 的治疗方法无疑会发生变化,特别是当我们对 SARS-CoV-2 感染的病理生理学有了更多的了解。