COVID-19的临床特征及药物治疗思考

Concerns about Clinical Characteristics and Pharmacotherapeutics of COVID-19

目的希望临床医生根据COVID-19的病理生理学特点,针对性选用治疗药物。方法综述COVID-19及SARS的相关文献,结合笔者的工作体会,总结出COVID的精准治疗方法。结果发现氧化自由基是发病的重要机理之一,细胞免疫力下降体现在疾病的全过程,而且与疾病严重性成正比,炎性因子广泛增高,但有些是正向作用(如IL-6),而有些是负向作用(如IL-8),可能是机体复杂的调节结果。结论COVID-19病人应常规抗氧化物治疗,常规使用提高细胞免疫力的药物,虽然有“炎性风暴”也不提倡应用糖皮质激素。

OBJECTIVE Clinicians are expected to select therapeutic drugs according to the pathophysiological characteristics of COVID-19.METHODS By referring to the related literature of COVID-19 and SARS,and combining the author's working experience,the precise treatment method of COVID-19 was summarized.RESULTS Oxidative radicals were found to be one of the important mechanisms of pathogenesis.Cellular immunity declines throughout the course of the disease and was proportional to the severity of the disease.Inflammatory factors were increased widely,but some were positive(such as IL-6)and some were negative(such as IL-8),which may be the result of complex regulation of the body.CONCLUSION Patients with COVID-19 should be routinely treated with antioxidants and Immunity enhancing drugs.Glucocorticoids are not recommended,atlthough the“inflammatory storm”do exist.