COVID-19治疗药物的研究进展

新型冠状病毒肺炎COVID-19 (corona virus disease 2019)是由新型冠状病毒SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2)感染所致的疾病。目前尚无特异性针对该病毒的抗病毒药物,临床上仍以支持治疗和对症治疗为主。直接靶向病毒和靶向宿主是抗病毒药物研发的两个策略,目前针对COVID-19治疗药物的研发,在这两个方向也都有相关的研究进展。现就文献报道的潜在抗SARS-CoV-2药物进行综述,旨在从靶向病毒和靶向宿主两个角度,讨论这些药物的抗病毒作用和潜力。同时结合中药在治疗新冠肺炎中发挥的作用,探讨和展望COVID-19药物治疗的策略。     

用于COVID-19潜在治疗的小分子药物及专利研究

本文总结了目前国内外针对2019新型冠状病毒肺炎有潜在治疗作用的小分子药物及研究进展,并重点对临床试验的热点药物如洛匹那韦/利托那韦、磷酸氯喹、瑞德西韦等相关专利进行了详细的分析与解读,以期为进行2019新型冠状病毒相关研究与药物临床应用的临床医生、医药企业、研究机构等提供有益的参考。     

COVID-19合并肺血栓栓塞症的临床特点

目的 探讨新型冠状病毒肺炎（COVID-19）合并肺血栓栓塞症的临床特点。方法 收集2022年12月—2023年1月27例COVID-19合并肺血栓栓塞症患者资料,根据临床信息、实验室检查、心电图、超声心动图、影像学检查和诊治方案等资料,总结患者的临床及预后特征。结果 27例患者中男12例,女15例,年龄64～93岁,平均（71.78±9.21）岁。既往有冠心病9例,恶性肿瘤7例,慢性阻塞性肺疾病4例,陈旧性肺结核2例,肺间质纤维化1例;临床主要表现为活动后气促、咳嗽、发热及胸腔积液,多数患者心电图表现为胸导联T波倒置（12/27）;超声表现为下肢深静脉血栓形成（13/27）;CT影像学主要表现为双肺多发磨玻璃影（21/27）、实变影（17/27）、段肺动脉栓塞（23/27）、亚段及以下肺动脉栓塞（10/27）。11例伴右心功能不全,入院30 d内死亡2例,均为高龄患者。结论 当恶性肿瘤和慢性心肺疾病患者出现不能解释的呼吸困难等表现时应考虑COVID-19合并肺血栓栓塞症的可能,影像学多表现为双肺磨玻璃影伴段及以下肺动脉栓塞,其中合并右心室功能不全的高龄患者预后不佳。     

抗COVID-19药物的研究进展

自2019年末SARS-CoV-2病毒引起的新冠疫情COVID-19 (也称为2019-nCoV)暴发以来,快速传播,席卷全球。除了研发有效疫苗,迫切需要寻找安全有效的抗新冠病毒药物来对抗这种疾病。FDA紧急授权的paxlovid、molnupiravir、sotrovimab和bebtelovimab被证明对Omicron有效。本文综述了3年来全球对该病毒有效的抑制剂,包含受体抑制剂、抗体、天然产物抑制剂、合成抑制剂及临床上对其他RNA病毒有效的广谱抗病毒药物的研发进展。     

COVID-19病情进展相关临床特征的meta分析

目的 探讨与COVID-19病情进展相关的危险因素。方法 检索COVID-19临床研究相关文献,截至2020年3月2日。采用Stata 12.0进行meta分析。共纳入7篇病例对照研究,涉及1 541例COVID-19患者,包括139例危重型和1 402例非危重型。比较2组患者入院时的临床特征、实验室检查结果、CT表现及并发症。结果 ①危重型患者的平均年龄显著高于非危重型患者[（62.13±14.08）vs（46.08±15.57）,WMD=14.57,95%CI 13.28~15.86,P<0.001]。②伴有基础疾病的COVID-19患者更有可能发展为危重型（62.6% vs 23.0%,OR=4.90,95%CI 3.31~7.26,P<0.001）,尤其是伴有慢性阻塞性肺病的患者（OR=14.71,95%CI 4.84~44.68,P<0.001）。发热是患者入院时最常见的症状（86.5%,1 297/1 500）,但入院时体温高低与疾病进展的严重程度无关。③入院时出现呼吸困难和CT检查提示双侧肺炎的患者发展为危重型的风险增加（OR=6.83,95%CI 4.58~10.16,P<0.001;OR=1.80,95%CI 1.09~2.96,P=0.021）。④约51.7%和57.1%的COVID-19危重型患者并发急性呼吸窘迫综合征和心脏病变,而休克和肾损伤的发生率相对较低,分别为19.8%和8.6%。提示COVID-19患者在临床诊治过程中进行心、肺、肾功能检查十分重要。⑤危重型患者乳酸脱氢酶（LDH）水平显著高于非危重型患者[（434.84±208.68）vs（235.45±75.75）,WMD=141.79,95%CI112.44~171.15,P<0.001],并且LDH升高的患者更有可能发展为危重型（72.5% vs 37.9%,OR=3.94,95%CI 2.25~6.93,P<0.001）,提示LDH水平与疾病严重程度相关。结论 高龄、存在基础疾病、入院时出现呼吸困难和双侧肺炎可能是COVID-19发展为危重型的潜在危险因素。LDH可作为疾病进展的临床监测指标。     

COVID-19普通型患者药物治疗管理模式的建立与实践

目的 梳理总结药师在COVID-19普通型患者药物治疗管理过程中的作用,为疫情特殊时期的医院药学工作提供参考。方法 根据实际工作情况,结合文献查阅,阐述COVID-19疫情防控时期临床药师为普通型患者提供药物治疗管理的具体实践和探索。结果 临床药师积极参与COVID-19普通型患者的诊治医疗活动,展开药物治疗管理,充分做好药物治疗分析,及时识别各类药物不良反应、药物相互作用等,参与多学科协作诊疗讨论,提供药物信息,为患者提供科学、合理和个体化的给药方案。结论 面对突发疫情事件,临床药师充分利用信息系统,及时调整药学工作应对策略,发挥药学特长,保障患者安全合理用药。     

新型冠状病毒肺炎患者肝损伤的原因及保肝药物治疗

新型冠状病毒（SARS-CoV-2）感染引起的新型冠状病毒肺炎（COVID-19）患者临床表现出不同程度的肝损伤。一系列研究表明细胞因子风暴、SARS-CoV-2病毒所致的胆管细胞损伤以及药物性肝毒性可以诱导继发性肝损伤,对不同因素所致的肝损伤的机制以及保肝药物治疗进行综述,以期为后续深入揭示该方面的研究提供参考支持。     

抗COVID-19药物的临床分析研究进展

洛匹那韦、利托那韦和利巴韦林是《新型冠状病毒感染的肺炎诊疗方案（试行第五版）》的推荐药物。通过研究近年来洛匹那韦、利托那韦和利巴韦林临床药物分析的进展概况,重点关注药物在血浆中的多种测定方法,包括HPLC、LC-MS、MS、分光光度法、毛细管电泳法、免疫法等,为开展治疗药物监测工作提供参考。     

武汉某院早期COVID-19患者临床特征与诊疗数据的回顾性研究

目的:明确及分析某院收治COVID-19肺炎患者的临床资料、特征及诊疗数据.方法:回顾性收集某院自2019年12月31日收治案例,均依指南确诊,分析患者流行病资料、检验及影像学资料、治疗方案等.患者最迟出院于2020年2月8日.结果:54名患者性别比为1∶1,平均年龄56.5岁,男性平均年龄63.4岁,女性平均年龄49...     

COVID-19患者机体多器官组织病理改变研究进展

新型冠状病毒肺炎(COVID-19)疫情严峻,新型冠状病毒(SARS-Co V-2)的变异株也在不断出现,防疫难度攀升。该文以SARS-Co V-2感染人体后引起机体多器官复杂病变为基础,将COVID-19患者肺、心、脑、肝、肾、胃肠道及胎盘等多个器官的病理变化特征进行阶段性的归纳,以为后续研究该病的发病机制和防治手段提供可能的依据。     

基于COVID-19“痰栓”本质的治疗思考

目的根据新型冠状病毒肺炎(COVID-19)病理特征,探讨"痰栓"的本质、黏液溶解剂治疗的可行性及其药物选择。方法综述COVID-19病理特征等相关文献,结合笔者的工作体会,总结出COVID-19黏液溶解剂治疗方法。结果"痰栓"并不是脓痰;"痰栓"中的黏液成分中,均含有大量的酸性黏蛋白。黏液溶解剂氨溴索盐酸盐与乙酰半胱氨酸对COVID-19具有重要的治疗作用。结论对COVID-19病人应常规使用黏液溶解剂进行治疗。     

托珠单抗在新型冠状病毒肺炎的应用研究探讨

2019年12月以来,新型冠状病毒肺炎(Coronavirus Disease 2019,COVID-19)在武汉暴发并蔓延至全国,给整个社会带来巨大的挑战。部分COVID-19感染者早期发病并不十分凶险,但后期会突然加速进展,病人很快进入多脏器功能衰竭的状态,李兰娟院士等提出了"细胞因子风暴"概念。但目前并没有特效药物,认为IL-6是诱发细胞因子风暴的重要通路,本文结合相关文献的复习和分析,旨在综述IL-6受体阻断剂托珠单抗在新型冠状病毒肺炎危重患者使用的可行性。     

托珠单抗在新型冠状病毒治疗中的临床药学指引

2019年12月末国在内外相继出现新型冠状病毒肺炎（corona virus disease-19,COVID-19）病例。有专家指出COVID-19感染者病情的突然加重可能和"细胞因子风暴"（炎症风暴）有关,目前并无针对于此的特效药。托珠单抗为IL-6拮抗剂,很可能阻断细胞因子风暴进而阻止COVID-19患者向重症转变。但因证据有限,临床工作者在实践中面临着许多问题,如缺乏托珠单抗在一般和特殊人群中的详细用药指导,推荐方案的依据不明确等。本文就该药物的基本信息、国内外研究现状、相互作用、不良反应等方面进行概述,以期为临床用药提供参考。     

新型冠状病毒肺炎病毒性脓毒症治疗策略研究进展

新型冠状病毒肺炎（COVID-19）已造成全球疫情并仍在持续蔓延。大量COVID-19重症或危重症患者的临床表现符合脓毒症和脓毒症休克的诊断标准,研究其发病机制和治疗策略对COVID-19的防控有重要意义。对COVID-19病毒性脓毒症的临床特征和治疗进展做一综述。     

新型冠状病毒肺炎疫苗的临床试验研究进展

新型冠状病毒肺炎(COVID-19)大流行推动了COVID-19疫苗的研发速度.目前,已有99个COVID-19疫苗处于临床评价阶段,其中22个已进入临床Ⅲ或Ⅳ期,许多疫苗已获紧急使用授权.本文对COVID-19疫苗的临床试验开展情况进行综述,旨在加深人们对COVID-19疫苗有效性和安全性的认识.     

COVID-19 Clinical Diagnostics and Testing Technology

Given the global nature of the coronavirus disease 2019 (COVID-19) pandemic, the need for disease detection and expanding testing capacity remains critical priorities. This review discusses the technological advances in testing capability and methodology that are currently used or in development for detecting the novel coronavirus. We describe the current clinical diagnostics and technology, including molecular and serological testing approaches, for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) testing as well as address their advantages and limitations. Nucleic acid amplification technology for molecular diagnostics remains the gold standard for virus detection. We highlight alternative molecular detection techniques used for developing novel COVID-19 diagnostics on the horizon. Antibody response against SARS-CoV-2 remains poorly understood and proper validation of serology tests is necessary to demonstrate their accuracy and clinical utility. In order to bring the pandemic under control, we must speed up the development of rapid and widespread testing through improvements in clinical diagnostics and testing technology as well as access to these tools.     

COVID-19: Clinical aspects and therapeutics responses

COVID-19 has created havoc in the world by causing thousands of demises in a short period of time. Up till now, several attempts have been made for potential therapeutics against SARS-COV2. In this retrospective, single-center study, we extracted data from 122 COVID-19, RT-PCR confirmed patients. who were treated with a new treatment strategy of lianhuaqingwen with Arbidol Hydrochloride. The patients were either asymptomatic or had mild symptoms for COVID-19 disease. Of 122 patients 21 (17.21%) patients developed severe conditions of COVID-19, while total 111 (90.9%) experienced mild symptoms such as fever in 93 (76.22%) patients, cough in 23 (20.17%) and muscle pain were observed in total 8 (7%) patients. Furthermore our newly applied drugs combination (Lianhuaqingwen and Arbidol Hydrochloride) showed therapeutic effects in 5–7 days in patients with mild symptoms with 98% recovery rate. These results indicate that COVID-19 patients with mild symptoms can be treated with Lianhuaqingwen and Arbidol Hydrochloride. However, extensive clinical investigations are required to confirm the effectiveness of these drugs.     

Knowledge about COVID-19 and beliefs about and use of herbal products during the COVID-19 pandemic: A cross-sectional study in Saudi Arabia

The lack of treatment options for COVID-19 has raised many concerns among populations worldwide, which has led to many attempts to find alternative options to prevent the transmission of the disease or to alleviate the progression of the infection, including focusing more on preventive measures (to prevent transmission to other individuals) and the use of natural products and herbal extracts to increase immunity and decrease the probability of getting infected. This study explored the knowledge of the population of the Kingdom of Saudi Arabia (KSA) about COVID-19 preventive measures and their belief about the consumption of herbal products for the prevention of COVID-19 infection. A total of 5,258 individuals participated in this study. Participants’ knowledge about the appropriate COVID-19 preventive measures in terms of handwashing procedures, self-quarantine and social distancing was moderate, with a mean score of 5.5 (SD: 1.7) out of 10 (representing around 55.0% of the total score). About 22.1% (n = 1,161) of the participants reported that they have used herbal products or nutritional supplements during the pandemic period, to protect themselves from the disease. Social media and the Internet (39.4%, n = 372) were the main motivators for the participants to try herbal products. Vitamin C was the most commonly used food supplement to increase immunity and reduces the chance of contracting COVID-19. Our study demonstrated that the general population in Saudi Arabia has a moderate level of knowledge about COVID-19 transmission and preventive measures. A considerable proportion of the population reported the use of herbal products or food supplements in order to protect themselves from the disease. Policymakers are suggested to provide further educational campaigns that increase population knowledge about the disease transmission routes and preventive measures. In addition, the use of herbal products should be evidence-based to ensure patient safety.