新型冠状病毒肺炎临床治疗药物最新研究进展

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)正在世界范围内流行.作为冠状病毒,新型冠状病毒(SARS-CoV-2)和严重急性呼吸综合征冠状病毒(SARS-CoV)都通过人血管紧张素转化酶2(ACE2)受体侵入宿主细胞.面对疫情异常严峻的现状,目前尚缺乏疫苗和尚无特异性针对该病毒...     

儿童新冠状病毒肺炎治疗药物研究进展

2019年12月,湖北省武汉市出现首批病因不明的肺炎患者,后经证实,该肺炎系一种病源尚未明确的新型冠状病毒[1]。2020年1月12日,世界卫生组织(WHO)将该新型冠状病毒命名为2019新型冠状病毒(2019 novel coronavirus disease,2019-nCoV),后根据病毒命名原则正式改名为严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2),而由该病毒感染引起的疾病被称为新型冠状病毒肺炎(corona virus disease 2019,COVID-19)。     

口服小分子抗新型冠状病毒药物的研究进展

新型冠状病毒肺炎是由严重急性呼吸道综合征冠状病毒2引起的急性呼吸道传染病,是近百年来人类遭遇的影响范围最广的全球性大流行疾病。抗病毒药物是治疗新型冠状病毒感染的首选。口服小分子抗新型冠状病毒药物使用方便,且适用于轻中症患者。目前小分子抗新型冠状病毒药物有血管紧张素转换酶2(ACE2)抑制剂、膜融合抑制剂、RNA聚合酶抑制剂和3CL蛋白酶抑制剂。归纳了口服小分子抗新型冠状病毒药物的研究进展,为口服小分子抗新型冠状病毒药物的研发提供思路。     

《新型冠状病毒感染诊疗方案(试行第十版)》解读

随着对新型冠状病毒(SARS-CoV-2)认识的深入，为做好后续诊疗工作，SARS-CoV-2感染诊疗方案不断更新。该文对《新型冠状病毒感染诊疗方案(试行第十版)》进行解读，并与《新型冠状病毒肺炎诊疗方案》(试行第九版)比较，重点介绍新版诊疗方案的更新要点，以便更好地应用于临床实践。     

儿童新型冠状病毒肺炎药物治疗研究进展

新型冠状病毒(severe acute respiratory syndrome corona virus,SARS-CoV)-2感染在全球暴发,目前尚无明确有效的抗病毒药物治疗SARS-CoV-2感染.结合以往临床一线治疗新型冠状病毒肺炎(corona virus disease 2019,COVID-19)的经验,...     

新型冠状病毒感染疫情中ACEI的争议：下结论还为时尚早

近期,新型冠状病毒感染合并高血压的患者,是否应停用血管紧张素转换酶抑制剂(ACEI)引起了争议。血管紧张素转换酶2(ACE2)是血管紧张素转换酶(ACE)的同源物,两者在血压调控和肺损伤中发挥重要作用。ACE2也是新型冠状病毒感染呼吸道上皮细胞的作用靶点。目前,关于ACEI对新型冠状病毒感染患者的ACE2调控效应出现了不同理论,ACEI/ARB对ACE2的调控效应尚无定论。此外,目前研究结果多数来自于动物实验,尚无临床数据。由于证据有限,因此使用ACEI/ARB类降压药的新型冠状病毒感染患者暂不必换药。     

COVID-19相关性心血管疾病的研究进展

新型冠状病毒肺炎(COVID-19)已迅速发展成全球卫生紧急事件.新型冠状病毒,即SARS-CoV-2,可影响多个器官,特别是肺脏和心脏.研究发现心脏生物标志物特别是超敏肌钙蛋白(hs-cTnI)和肌酸激酶(CK)的升高,在新型冠状病毒肺炎患者中很常见,有助于疾病诊断和危险分层.同时发现既往有心血管疾病的患者更易感染新...     

序言

2019年12月以来,新型冠状病毒(Novel Coronavirus)感染的肺炎在武汉暴发。2020年1月12日,世界卫生组织(WHO)将这种致病病毒命名为"2019新型冠状病毒(2019-nCoV)"。2月7日,国家卫生健康委员会将新型冠状病毒感染的肺炎暂命名为"新型冠状病毒肺炎(Novel Coronavirus Pneumonia)",简称"新冠肺炎(NCP)"。2月11日,WHO将新型冠状病毒所致的疾病正式命名为"COVID-19"。国际病毒分类学委员会将新型冠状病毒正式命名为"SARS-CoV-2"。截至2020年2月28日,我国已累计报告新冠肺炎确诊病例78 959例,死亡2 791例。新冠肺炎疫情是新中国成立以来在我国发生的传播速度最快、感染范围最广、防控难度最大的一次重大突发公共卫生事件。     

新型冠状病毒肺炎相关心血管疾病风险及其治疗中的药学监护

新型冠状病毒肺炎(COVID-19)是一种由新型冠状病毒(SARS-CoV-2)引起的传染性疾病.多项研究显示,SARS-CoV-2感染除了导致病毒性肺炎,还可能产生潜在的心血管危害,增加已有心血管疾病患者潜在的并发症和死亡风险.其发生机制尚不清楚,可能由于SARS-CoV-2通过血管紧张素转化酶2(ACE2)途径侵入...     

浅谈儿童新型冠状病毒感染的核酸检测

2019年12月首发于湖北省武汉市的新型冠状病毒肺炎(corona virus disease 2019,COVID-19)疫情火速蔓延,并迅速扩散,2020年2月11日国际病毒学分类委员会正式将新型冠状病毒命名为严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)[1]。2020年2月2日,国家卫生健康委员会发布的《关于做好儿童和孕产妇新型冠状病毒感染的肺炎疫情防控工作的通知》中明确指出,儿童和孕产妇是COVID-19的易感人群。为了更好地指导和规范全国COVID-19的诊治工作,国家卫生健康委员会发布的《新型冠状病毒肺炎诊疗方案(试行第六版)》将核酸检测和基因测序作为COVID-19的确诊依据。     

洛匹那韦/利托那韦抗新型冠状病毒治疗的可行性及临床评价

目的 评价洛匹那韦/利托那韦抗新型冠状病毒治疗的应用可行性、临床效果及安全性。方法 最近在中国暴发的新型冠状病毒肺炎(简称新冠肺炎)疫情,目前尚无针对性强的抗病毒药物,临床尝试"老药新用",以2003年严重急性呼吸综合征(SARS)和2012年中东呼吸综合征(MERS)疫情中使用的一线抗病毒药物洛匹那韦/利托那韦来抗新型冠状病毒治疗。分析该药的抗病毒药理作用、临床应用可行性,评价其临床应用效果和安全性。结果 洛匹那韦/利托那韦治疗冠状病毒感染性疾病有一定临床基础,可重建宿主的免疫功能,抗新型冠状病毒有一定疗效,但有较高的耐药屏障。结论 洛匹那韦/利托那韦用于抗新型冠状病毒治疗可行,临床疗效较好,但应用期间要加强药学监护,尤其是合并用药和特殊人群应用时,注重安全、合理用药。     

Drugs Used in the Treatment of Multiple Sclerosis During COVID-19 Pandemic: A Critical Viewpoint

Since COVID-19 has emerged as a word public health problem, attention has been focused on how immune-suppressive drugs used for the treatment of autoimmune disorders influence the risk for SARS-CoV-2 infection and the development of acute respiratory distress syndrome (ARDS). Here, we discuss the disease-modifying agents approved for the treatment of multiple sclerosis (MS) within this context. Interferon (IFN)-β1a and -1b, which display antiviral activity, could be protective in the early stage of COVID-19 infection, although SARS-CoV-2 may have developed resistance to IFNs. However, in the hyperinflammation stage, IFNs may become detrimental by facilitating macrophage invasion in the lung and other organs. Glatiramer acetate and its analogues should not interfere with the development of COVID-19 and may be considered safe. Teriflunomide, a first-line oral drug used in the treatment of relapsing-remitting MS (RRMS), may display antiviral activity by depleting cellular nucleotides necessary for viral replication. The other first-line drug, dimethyl fumarate, may afford protection against SARS-CoV-2 by activating the Nrf-2 pathway and reinforcing the cellular defenses against oxidative stress. Concern has been raised regarding the use of second-line treatments for MS during the COVID-19 pandemic. However, this concern is not always justified. For example, fingolimod might be highly beneficial during the hyperinflammatory stage of COVID-19 for a number of mechanisms, including the reinforcement of the endothelial barrier. Caution is suggested for the use of natalizumab, cladribine, alemtuzumab, and ocrelizumab, although MS disease recurrence after discontinuation of these drugs may overcome a potential risk for COVID-19 infection.     

Treatment advice of small molecule antiviral drugs for elderly COVID-19北大核心CSCD

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly. © 2023 Publication Centre of Anhui Medical University. All rights reserved.     

新型冠状病毒肺炎治疗药物研发现状

目的 探讨新型冠状病毒肺炎(简称新冠肺炎)治疗药物研发现状、成效和存在的问题,并提出改进建议。方法 以国家卫生健康委员会《新型冠状病毒肺炎诊疗方案》中药物治疗的演变为切入点,结合临床治疗现状,总结各种治疗新型冠状病毒感染药物的特点,分析新冠肺炎疫情暴发以来登记注册拟开展的药物临床试验研究情况及存在的问题。结果 对于新冠肺炎,目前尚无特效抗病毒治疗方法,国家卫生健康委员会《新型冠状病毒肺炎诊疗方案》中所推荐的药物治疗也是基于突发疫情条件下的试用建议,且需严格监控。针对新冠肺炎疫情下登记注册拟开展的药物临床试验项目整体上普遍存在立题依据、研究基础和研究条件不充分,缺乏必要的临床前试验数据和质量保证体系等问题。结论 针对新冠肺炎,药物选择都是基于既往的严重急性呼吸综合征(SARS)、中东呼吸综合征(MERS)或其他新型流感病毒的治疗经验,积极的对症支持治疗仍是治疗的关键。针对新型冠状病毒的新药研发应回归到认真做好基于药物作用靶点、作用机制的活性筛选的基础工作。     

中和抗体在新型冠状病毒肺炎治疗中的重要意义:进展与展望

SARS-CoV-2感染是对全世界人类生命和健康的一大严重威胁,新型冠状病毒肺炎是由SARS-CoV-2感染引起的全球流行病.SARS-CoV-2病毒具有高度的传染性、诡异性和多变性.因此,新型冠状病毒肺炎的治疗是紧迫且有针对性的.然而,疫苗和目前使用的药物一般不具有上述特点.虽然新型冠状病毒肺炎的恢复期血浆在危重患者...     

新型冠状病毒肺炎诊疗方案推荐的潜在抗病毒药物述评

目的 为临床抗新型冠状病毒(SARS-CoV-2)治疗及药学监护提供参考。方法 结合SARS-CoV-2的特点和可能的致病机理,围绕国家卫生健康委员会《新型冠状病毒肺炎诊疗方案(试行第七版)》推荐的潜在抗病毒药物,以及中国药学会《新型冠状病毒感染:医院药学工作指导与防控策略专家共识》的相关内容,从这些药物的背景信息、药理作用、药物警戒等方面进行综合评述。结果 与结论通过综合述评,为临床新型冠状病毒肺炎的抗病毒治疗及药学监护提供了药物治疗学相关知识,也为抗SARS-CoV-2的药物研究提供了参考。     

Localized delivery of nanomedicine and antibodies for combating COVID-19

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been a major health burden in the world. So far, many strategies have been investigated to control the spread of COVID-19, including social distancing, disinfection protocols, vaccines, and antiviral treatments. Despite the significant achievement, due to the constantly emerging new variants, COVID-19 is still a great challenge to the global healthcare system. It is an urgent demand for the development of new therapeutics and technologies for containing the wild spread of SARS-CoV-2. Inhaled administration is useful for the treatment of lung and respiratory diseases, and enables the drugs to reach the site of action directly with benefits of decreased dose, improved safety, and enhanced patient compliance. Nanotechnology has been extensively applied in the prevention and treatment of COVID-19. In this review, the inhaled nanomedicines and antibodies, as well as intranasal nanodrugs, for the prevention and treatment of COVID-19 are summarized.     

Antivirals and the Potential Benefits of Orally Inhaled Drug Administration in COVID-19 Treatment

Coronavirus Disease 2019 (COVID-19) pandemic has been on the agenda of humanity for more than 2 years. In the meantime, the pandemic has caused economic shutdowns, halt of daily lives and global mobility, overcrowding of the healthcare systems, panic, and worse, more than 6 million deaths. Today, there is still no specific therapy for COVID-19. Research focuses on repurposing of antiviral drugs that are licensed or currently in the research phase, with a known systemic safety profile. However, local safety profile should also be evaluated depending on the new indication, administration route and dosage form. Additionally, various vaccines have been developed. But the causative virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has undergone multiple variations, too. The premise that vaccines may suffice to eradicate new and all variants is unreliable, as they are based on earlier versions of the virus. Therefore, a specific medication therapy for COVID-19 is crucial and needed in order to prevent severe complications of the disease. Even though there is no specific drug that inhibits the replication of the disease-causing virus, among the current treatment options, systemic antivirals are the most medically appropriate. As SARS-CoV-2 directly targets the lungs and initiates lung damage, treating COVID-19 with inhalants can offer many advantages over the enteral/parenteral administration. Inhaled drug delivery provides higher drug concentration, specifically in the pulmonary system. This enables the reduction of systemic side effects and produces a rapid clinical response. In this article, the most frequently (systemically) used antiviral compounds are reviewed including Remdesivir, Favipiravir, Molnupiravir, Lopinavir-Ritonavir, Umifenovir, Chloroquine, Hydroxychloroquine and Heparin. A comprehensive literature search was conducted to provide insight into the potential inhaled use of these antiviral drugs and the current studies on inhalation therapy for COVID-19 was presented. A brief evaluation was also made on the use of inhaler devices in the treatment of COVID-19. Inhaled antivirals paired with suitable inhaler devices should be considered for COVID-19 treatment options.     

氯喹抗病毒作用及其临床应用研究进展

2019年12月以来在国内外相继出现新型冠状病毒肺炎（COVID-19）病例。氯喹作为一种经典的抗疟药物，因体外试验和临床观察提示具有抗新冠病毒（SARS-CoV-2）活性而成为目前研究的热点。本文就氯喹抗病毒研究现状、药代动力学、临床应用等信息作一概述，以期为其后续抗新冠病毒作用的开发及临床合理应用提供参考。