α干扰素不同给药途径治疗新型冠状病毒肺炎疗效的文献综述

Literature Review on the Efficacy of Different Administration Routes of Interferon-αin the Treatment of COVID-19

目的:通过分析α干扰素不同给药途径用于严重急性呼吸综合征(severe acute respiratory syndrome,SARS)和中东呼吸综合征(Middle East respiratory syndrome,MERS)中抗病毒治疗的疗效,探索在新型冠状病毒肺炎(COVID-19)中α干扰素的最佳给药方法,寻找α干扰素注射液雾化使用治疗COVID-19的证据。方法:使用计算机于中国期刊全文数据库、维普中文科技期刊全文数据库、万方数据库、中国生物医文献数据库、PubMed和the Cochrane library等中外文数据库中检索相关研究;同时,使用世界卫生组织和中国国家疾控中心网站、国家卫生健康委网站对我国已发布的相关诊疗方案进行检索。最终纳入的文献按照循证药学的方法进行数据提取。结果:检索获得2105篇文献,最终纳入13篇。(1)皮下或肌内注射α干扰素用于SARS、MERS治疗的文献有9篇,且治疗成功案例较多;(2)鼻腔给予重组人α干扰素鼻喷剂用于预防SARS等常见呼吸道病毒感染的文献有1篇,需要更多临床试验进行验证;(3)未获得α干扰素注射剂雾化用于SARS、MERS治疗的临床研究。结论:皮下或肌内注射α干扰素为常用有效的给药方法,符合药品说明书的推荐,可尝试用于COVID-19的抗病毒治疗;目前尚无α干扰素注射液雾化用于冠状病毒感染的临床研究,后期可开展该剂型雾化治疗COVID-19的疗效观察和评估;另外,可开展雾化剂型和喷雾剂型的开发研究,进一步探索α干扰素不同剂型、不同给药途径用于COVID-19不同临床分型患者的临床需要,规避气溶胶感染和超药品说明书用药风险。

OBJECTIVE:Through analyzing the efficacy of antiviral treatment of different administration routes of interferon-αin the treatment of severe acute respiratory syndrome(SARS)and Middle East respiratory syndrome(MERS),so as to probe into the best administration route of interferon-αin the treatment of COVID-19 and seek for the evidence of interferon-αinjection in atomized therapy for COVID-19.METHODS:Relevant research in Chinese and foreign language databases including CNKI,VIP,Wanfang database,CBM,PubMed and the Cochrane Library were retrieved;at the same time,the issued related diagnosis and treatment scheme were searched from the website of World Health Organization,China National Disease Control and Prevention and National Health Commission in our country.Finally,the involved literature was extracted according to the method of evidence-based pharmacy.RESULTS:Totally 2105 studies were retrieved and 13 studies were finally enrolled.(1)there were 9 studies about subcutaneous or intramuscular injection of interferon-αfor SARS and MERS treatment,most were successful cases;(2)there was 1 study about nasal administration of recombinant human interferon-αnasal spray to prevent SARS and other common respiratory virus infection,which needed more clinical trials to verify;(3)there had no study about interferon-αinjection in atomized therapy for SARS and MERS treatment.CONCLUSIONS:Subcutaneous or intramuscular injection of interferon-αare the commonly used and effective methods of administration that meet the recommendations of the drug insert,which can be tried for antiviral treatment of COVID-19;currently there is no clinical research about interferon-αinjection in atomized therapy for coronavirus infection,observation and evaluation on the efficacy of this formulation in the treatment of COVID-19 can be carried out in the later period;in addition,the development and research of atomized and spray formulations can be carried out to further explore the different formulations and different administration routes of interferon-αin the treatment of different clinical classifications of patients with COVID-19,to avoid the risk of aerosol infection and off-label medication.