KEVID-19 Tshuaj: Puas Muaj Kev Ua Haujlwm?

COVID-19 Tshuaj: Puas muaj qhov ua haujlwm?

Daniel C. DeSimone, MD:

Nws yog tib yam tshuaj uas pom zoo los ntawm US Food and Drug Administration (FDA) rau kev kho tus mob coronavirus 2019 (COVID-19). Tab sis ntau lwm yam tshuaj twb tau sim.

Tam sim no FDA tau pom zoo cov tshuaj tiv thaiv kab mob remdesivir (Veklury) los kho COVID-19 rau cov neeg laus thiab menyuam yaus 12 thiab laus dua. Remdesivir tuaj yeem raug sau rau cov neeg mob hauv tsev kho mob nrog COVID-19 uas xav tau cov pa oxygen ntxiv lossis cov uas muaj kev pheej hmoo siab rau mob hnyav. Cov tshuaj no yog muab los ntawm kev txhaj tshuaj (rau hauv cov hlab ntsha) los ntawm daim tawv nqaij.

FDA tau pom zoo cov tshuaj Paxlovid rau kev siv thaum muaj xwm ceev. Txhua lub hnab muaj ob yam tshuaj: Naimatevir, uas thaiv cov haujlwm ntawm cov enzyme tshwj xeeb uas xav tau rau kev rov ua dua ntawm tus kabmob uas ua rau COVID-19; thiab cov tshuaj tiv thaiv kab mob ritonavir, uas pab txo qis kev tawg ntawm Naimatevir. Paxlovid tau txais kev pom zoo los kho tus mob me-rau-nruab nrab COVID-19 cov neeg mob hnub nyoog 12 xyoos thiab laus dua uas muaj kev pheej hmoo siab rau mob hnyav. Cov tshuaj no tuaj rau hauv cov ntsiav tshuaj thiab noj los ntawm qhov ncauj.

FDA tau pom zoo lwm yam tshuaj hu ua monuprevir rau kev siv xwm txheej ceev los kho cov neeg laus cov neeg laus uas muaj tus mob me me mus rau nruab nrab COVID-19 uas muaj feem yuav mob hnyav thiab leej twg tsis tuaj yeem siv lwm txoj kev kho mob. Cov tshuaj no tuaj rau hauv cov ntsiav tshuaj thiab noj los ntawm qhov ncauj.

FDA tau pom zoo siv tshuaj kho mob rheumatoid mob caj dab baricitinib (Olumiant) los kho COVID-19 hauv qee qhov xwm txheej. Cov ntsiav tshuaj Baricitinib zoo li tiv thaiv COVID-19 los ntawm kev txo qhov mob thiab ua rau muaj kev tiv thaiv kab mob. Baricitinib tuaj yeem siv rau hauv tsev kho mob cov neeg mob nrog COVID-19 uas nyob hauv lub tshuab ua pa lossis xav tau cov pa oxygen ntxiv.

Cov kws tshawb fawb tab tom kawm lwm yam kev kho mob uas muaj peev xwm rau COVID-19, suav nrog:

Cov tshuaj tiv thaiv kab mob. Cov kws tshawb fawb tab tom sim nrog cov tshuaj tiv thaiv kab mob favipiravir thiab merimepodib. Txoj kev tshawb nrhiav pom tias kev sib xyaw ntawm lopinavir thiab ritonavir tsis zoo.

Anti-inflammatory kev kho. Cov kws tshawb fawb tau kawm ntau yam tshuaj tiv thaiv kab mob los kho lossis tiv thaiv ntau yam kab mob hauv nruab nrog cev thiab lub ntsws raug mob los ntawm kev kis kab mob.

Dexamethasone. corticosteroid dexamethasone yog ib qho tshuaj tiv thaiv kab mob tam sim no nyob rau hauv kev tshawb nrhiav rau kev kho lossis tiv thaiv kev ua haujlwm ntawm lub cev thiab lub ntsws raug mob los ntawm kev mob. Txoj kev tshawb nrhiav pom tias cov tshuaj txo cov kev pheej hmoo ntawm kev tuag li ntawm 30 feem pua ​​​​ntawm cov neeg mob ntawm lub tshuab ua pa thiab li 20 feem pua ​​​​ntawm cov neeg uas xav tau cov pa ntxiv.

Lub National Institutes of Health pom zoo kom dexamethasone rau cov neeg mob pw hauv tsev kho mob nrog COVID-19 uas nyob hauv lub tshuab ua pa lossis xav tau cov pa oxygen ntxiv. Yog tias tsis muaj dexamethasone, lwm yam corticosteroids xws li prednisone, methylprednisolone, lossis hydrocortisone yuav raug siv. Rau cov kab mob COVID-19 tsawg dua, dexamethasone thiab lwm yam corticosteroids yuav ua rau muaj kev phom sij ntau dua li pab tau.

Qee zaum, remdesivir, tocilizumab, lossis baricitinib tuaj yeem ua ke nrog dexamethasone rau cov neeg mob hauv tsev kho mob uas nyob ntawm lub tshuab ua pa lossis xav tau oxygen ntxiv.

Immunotherapy. Cov kws tshawb fawb tau kawm txog kev tiv thaiv kab mob xws li cov ntshav plasma, mesenchymal qia hlwb, thiab cov tshuaj tiv thaiv monoclonal. Monoclonal antibodies yog cov proteins tsim nyob rau hauv lub chaw kuaj mob uas pab lub cev tiv thaiv kab mob tawm tsam cov kab mob.

Monoclonal antibody tshuaj suav nrog sotovelumab, banivirumab ua ke nrog eltersuvirumab, thiab casirimumab ua ke nrog idelweimab. Cov tshuaj no yog siv los kho cov neeg mob me mus rau nruab nrab COVID-19 uas muaj feem yuav mob hnyav los ntawm COVID-19. Kev kho mob yog muab raws li ib qho kev txhaj tshuaj (rau hauv cov hlab ntsha) hauv koj txhais caj npab raws li tus neeg mob sab nraud. Txhawm rau kom tau txais txiaj ntsig zoo, cov tshuaj no yuav tsum tau muab sai sai tom qab cov tsos mob ntawm COVID-19 tshwm sim thiab ua ntej mus pw hauv tsev kho mob. Qee cov tshuaj tiv thaiv kab mob monoclonal tsis tshua muaj txiaj ntsig zoo rau qee qhov txawv ntawm COVID-19.

Cov kws tshawb fawb kuj tau tshawb fawb txog kev kho mob ntshav plasma immunotherapy. FDA tau pom zoo rau kev siv thaum muaj xwm txheej ceev ntawm kev kho ntshav plasma los kho COVID-19. Convalescent plasma yog cov ntshav pub dawb los ntawm cov neeg mob COVID-19 zoo. Convalescent plasma uas muaj cov tshuaj tiv thaiv kab mob siab tuaj yeem siv los kho qee cov neeg mob hauv tsev kho mob nrog COVID-19 uas nyob rau theem pib ntawm tus kab mob lossis cov uas muaj kev tiv thaiv kab mob.

Kev tshawb nrhiav tshuaj rau qhov ua tau zoo tsis paub meej. Cov kws tshawb fawb tau kawm txog amlodipine thiab losartan. Tab sis nws tsis paub meej tias cov tshuaj no zoo npaum li cas rau kev kho lossis tiv thaiv COVID-19. Famotidine tsis suav hais tias muaj txiaj ntsig zoo hauv kev kho COVID-19.

Ivermectin. Cov tshuaj ivermectin yog siv los kho lossis tiv thaiv kab mob hauv cov tsiaj thiab tib neeg, tsis yog kho cov kab mob. Cov tshuaj no tsis tau pom zoo los ntawm FDA los kho lossis tiv thaiv COVID-19. Cov tshuaj no yuav ua rau mob hnyav yog tias noj ntau heev. Tsis txhob muab tshuaj rau tus kheej los kho lossis tiv thaiv COVID-19.

Hydroxychloroquine thiab chloroquine. Cov tshuaj tiv thaiv kab mob npaws no yav dhau los tau tso cai siv thaum muaj xwm txheej ceev los ntawm FDA thaum muaj tus kab mob COVID{0}} tshwm sim. Tab sis FDA tau thim qhov kev tso cai thaum kev soj ntsuam ntawm cov ntaub ntawv qhia tias cov tshuaj tsis muaj txiaj ntsig hauv kev kho COVID-19. Cov tshuaj no kuj tuaj yeem ua rau mob plawv.

Cov tshuaj tiv thaiv COVID-19. Cov kws tshawb fawb tab tom kawm tshuaj los tiv thaiv COVID-19 ua ntej thiab tom qab kis tus kab mob.

FDA tau tso cai siv thaum muaj xwm txheej ceev ntawm monoclonal antibodies cabirimumab ua ke nrog idevumab thiab banivirumab ua ke nrog eltersuvirumab. Cov tshuaj no tuaj yeem siv los kho cov tib neeg uas nyuam qhuav kis tus kab mob COVID-19 lossis cov uas muaj kev pheej hmoo kis tus kab mob thiab cov uas muaj feem yuav mob hnyav. Thaum ib tus neeg nyob hauv tsev laus lossis tsev loj cuj tau kis tus kabmob COVID-19 tsis ntev los no, cov neeg uas muaj kev pheej hmoo kis tau tus mob yuav suav nrog cov neeg nyob ntawd. Txoj kev kho no yog rau cov neeg uas tsis tau txhaj tshuaj tiv thaiv tag nrho lossis cov uas tau txhaj tshuaj tag nrho tab sis muaj kev tiv thaiv kab mob.

FDA kuj tau pom zoo siv thaum muaj xwm txheej ceev ntawm monoclonal antibody tesagravirumab ua ke nrog sigavirumab (Evusheld) rau kev tiv thaiv COVID-19 hauv qee cov neeg tiv thaiv kab mob lossis cov neeg muaj keeb kwm muaj kev cuam tshuam loj rau COVID-19 tshuaj tiv thaiv .

Nws tsis paub tias cov tshuaj no puas muaj txiaj ntsig tiv thaiv COVID-19. Nws yog ib qho tseem ceeb kom ua tiav cov kev tshawb fawb txog kev kho mob kom pom tias cov tshuaj no puas ua haujlwm tiv thaiv COVID-19.

Txawm hais tias koj tau hnov ​​​​tias cov tshuaj no yuav pab tau, tsis txhob sim lawv yam tsis muaj daim ntawv tshuaj thiab koj tus kws kho mob pom zoo. Cov tshuaj no tuaj yeem muaj kev phiv loj heev. Cov tshuaj no tau tshwj tseg rau cov neeg mob hnyav uas xav tau kev saib xyuas ntawm cov neeg ua haujlwm kho mob.

Nrog

Daniel C. DeSimone, MD