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近期对 COVID-19 管理的回顾:诊断、治疗和疫苗接种。

Recent review of COVID-19 management: diagnosis, treatment and vaccination.

机构信息

Department of Pharmaceutics and Pharmaceutical Technology, L M College of Pharmacy, Navrangpura, Ahmedabad, 380009, Gujarat, India.

Department of Biotechnology, Science, Innovation, and Society Research Lab 115, Hexagon (SMV), Vellore Institute of Technology, Vellore, 632014, Tamil Nadu, India.

出版信息

Pharmacol Rep. 2022 Dec;74(6):1120-1148. doi: 10.1007/s43440-022-00425-5. Epub 2022 Oct 10.

Abstract

The idiopathic Coronavirus disease 2019 (COVID-19) pandemic outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached global proportions; the World Health Organization (WHO) declared it as a public health emergency during the month of January 30, 2020. The major causes of the rise of new variants of SARS-CoV-2 are genetic mutations and recombination. Some of the variants with high infection and transmission rates are termed as variants of concern (VOCs) like currently Omicron variants. Pregnant women, aged people, and immunosuppressed and compromised patients constitute the most susceptible human population to the SARS-CoV-2 infection, especially to the new evolving VOCs. To effectively manage the pathological condition of infection, the focus should be directed towards prevention and prophylactic approach. In this narrative review, we aimed to analyze the current scenario of COVID-19 management and discuss the treatment and prevention strategies. We also focused on the complications prevalent during the COVID-19 and post-COVID period and to discuss the novel approaches developed for mitigation of the global pandemic. We have also emphasized on the COVID-19 management approaches for the special population including children, pregnant women, aged groups, and immunocompromised patients. We conclude that the advancements in therapeutic and pharmacological domains have provided opportunities to develop and design novel diagnosis, treatment, and prevention strategies. New advanced techniques such as RT-LAMP, RT-qPCR, High-Resolution Computed Tomography, etc., efficiently diagnose patients with SARS-CoV-2 infection. In the case of treatment options, new drugs like paxlovid, combinations of β-lactum drugs and molnupiravir are found to be effective against even the new emerging variants. In addition, vaccination is an essential approach to prevent the infection or to reduce its severity. Vaccines for against COVID-19 from Comirnaty by Pfizer-BioNTech, SpikeVax by Moderna, and Vaxzevria by Oxford-AstraZeneca are approved and used widely. Similarly, numerous vaccines have been developed with different percentages of effectiveness against VOCs. New developments like nanotechnology and AI can be beneficial in providing an efficient and reliable solution for the suppression of SARS-CoV-2. Public health concerns can be efficiently treated by a unified scientific approach, public engagement, and better diagnosis.

摘要

由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的特发性 2019 年冠状病毒病(COVID-19)大流行已蔓延至全球范围;世界卫生组织(WHO)于 2020 年 1 月 30 日宣布其为公共卫生紧急事件。SARS-CoV-2 新变体的主要成因是基因突变和重组。一些具有高感染和传播率的变体被称为关注变体(VOCs),如当前的奥密克戎变体。孕妇、老年人以及免疫抑制和受损的患者是最易感染 SARS-CoV-2 的人群,尤其是新出现的 VOCs。为了有效控制感染的病理状况,重点应放在预防和预防措施上。在本叙述性综述中,我们旨在分析 COVID-19 管理的现状,并讨论治疗和预防策略。我们还重点关注 COVID-19 期间和 COVID-19 后期间普遍存在的并发症,并讨论为减轻全球大流行而开发的新方法。我们还强调了包括儿童、孕妇、老年人和免疫抑制患者在内的特殊人群的 COVID-19 管理方法。我们的结论是,治疗和药理学领域的进步为开发和设计新的诊断、治疗和预防策略提供了机会。实时环介导等温扩增(RT-LAMP)、实时定量聚合酶链反应(RT-qPCR)、高分辨率计算机断层扫描等新技术可有效诊断 SARS-CoV-2 感染患者。在治疗选择方面,发现新药如 paxlovid、β-内酰胺类药物和莫那比拉韦的联合用药对新出现的变体也有效。此外,接种疫苗是预防感染或降低感染严重程度的重要方法。辉瑞-生物技术公司的 Comirnaty、莫德纳的 SpikeVax 和牛津-阿斯利康的 Vaxzevria 等针对 COVID-19 的疫苗已获得批准并广泛使用。同样,针对 VOCs 也开发了具有不同有效率的多种疫苗。纳米技术和人工智能等新发展可以为提供 SARS-CoV-2 的有效可靠解决方案带来益处。通过统一的科学方法、公众参与和更好的诊断,可以有效地治疗公共卫生问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac65/9549062/8cfdfdbc0e4e/43440_2022_425_Fig1_HTML.jpg

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