Division Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, USA.
Department of Critical Care, King's College London, Guy's & St Thomas' NHS Foundation Hospital, Westminster Bridge Road, London SE1 7EH, United Kingdom.
Crit Care Clin. 2022 Jul;38(3):587-600. doi: 10.1016/j.ccc.2022.02.002. Epub 2022 Feb 14.
Severe acute respiratory syndrome coronavirus 2 infection leads to dysregulation of immune pathways. Therapies focusing on suppressing cytokine activity have some success. Current evidence supports the use of dexamethasone in hospitalized patients requiring oxygen to decrease mortality. Interleukin-6 inhibitors, like tocilizumab and sarilumab, are also beneficial in hypoxemic patients, if used early. Janus kinase inhibition in combination with glucocorticoids is emerging as a potential therapeutic option for patients with moderate to severe symptoms. Data on the role of anakinra, hyperimmune immunoglobulin/convalescent plasma, or plasma purification are limited.
严重急性呼吸综合征冠状病毒 2 感染导致免疫途径失调。专注于抑制细胞因子活性的疗法取得了一些成功。目前的证据支持在需要吸氧的住院患者中使用地塞米松以降低死亡率。白细胞介素 6 抑制剂，如托珠单抗和沙利鲁单抗，在低氧血症患者中早期使用也有益。Janus 激酶抑制与糖皮质激素联合使用，作为中重度症状患者的潜在治疗选择正在出现。关于阿那白滞素、高免疫球蛋白/恢复期血浆或血浆净化作用的数据有限。
