State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Department of Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
Aging Dis. 2023 Dec 1;14(6):1967-1976. doi: 10.14336/AD.2023.0318.
The COVID-19 pandemic, often referred to as the geropandemic, has put immense pressure on global healthcare systems worldwide, leading to a rush in the development and approval of medications for the treatment of the viral infection. Clinical trials on efficacy and safety had a limited spectrum on inclusion and endpoints because of the urgent need for fast results. The chronologically and biologically aged population is especially at risk for severe or lethal disease, as well as treatment-associated toxicity. In China, the growing elderly population segment has been a focus in public health measurements of COVID-19, guiding towards herd immunity with a mild variant, thus minimizing overall deaths and morbidity. While the COVID-19 pandemic has now been reclassified and the virus weakened, there is a clear need for novel therapies to protect the elderly. This paper reviews the current safety and efficacy of available COVID-19 medications in China, with a specific focus on 3CL protease inhibitors and the aging population. The current COVID wave in China has demonstrated a significant impact on the elderly and the need for new drugs that are effective at low doses and can be used alone, without harmful side effects, generation of viral resistance, and drug-drug interactions. The rush to develop and approve COVID-19 medications has brought up important questions about the balance between speed and caution, resulting in a pipeline of novel therapies now moving through clinical trials, including third-generation 3CL protease inhibitors. A majority of those therapeutics are being developed in China.
COVID-19 大流行，通常被称为老年流行病，给全球医疗系统带来了巨大压力，导致治疗病毒感染的药物的研发和批准迅速推进。由于迫切需要快速的结果，临床试验的疗效和安全性的纳入范围和终点有限。由于年龄增长而导致的生物学和时间上的老龄化人口尤其面临严重或致命疾病以及与治疗相关的毒性的风险。在中国，不断增长的老年人口一直是 COVID-19 公共卫生措施的重点，通过轻度变异来引导群体免疫，从而最大限度地减少总死亡人数和发病率。虽然 COVID-19 大流行现已重新分类，病毒也有所减弱，但显然需要新的疗法来保护老年人。本文综述了中国目前可用的 COVID-19 药物的安全性和疗效，特别关注 3CL 蛋白酶抑制剂和老龄化人口。目前中国的 COVID 浪潮对老年人产生了重大影响，需要新的药物，这些药物的疗效高，剂量低，可以单独使用，没有有害的副作用、病毒耐药性和药物相互作用的产生。研发和批准 COVID-19 药物的热潮引发了关于速度和谨慎之间平衡的重要问题，导致现在有一批新的疗法正在通过临床试验，包括第三代 3CL 蛋白酶抑制剂。这些疗法中的大多数都在中国开发。
