Medicamentos e tratamentos para a Covid-19

abstract Approximately 2,000 clinical studies have been conducted in the world to investigate approved drugs and drug candidates for Covid-19, including small molecules and biologicals, not to mention vaccines. The repositioning of drugs, the most explored strategy, has not led to the identification of any new antiviral against Covid-19. Despite its approval for emergency use by the US regulatory agency, remdesivir has shown only modest results in clinical studies. Dexamethasone, which contributed to reduce mortality in critically ill patients receiving mechanical ventilation or oxygen, is a corticosteroid that has anti-inflammatory and immunosuppressive properties. Biological drugs, such as monoclonal antibodies, interferons, specific proteins, and anticoagulants are being evaluated in several clinical studies to assess their role in Covid-19 therapy. The World Health Organization (WHO) has warned that the coronavirus may never disappear even with the advent of an eventual vaccine, highlighting the urgency for the development of innovative drugs. The most realistic scenario involves the development of specific antivirals against Sars-CoV-2 for the safe and effective treatment of the disease.

摘要 目前全球已开展约2000项临床试验，旨在探究适用于新型冠状病毒肺炎（COVID-19）的已获批药物与候选药物，涵盖小分子药物及生物制剂，更遑论疫苗。作为当前研究最为广泛的策略，药物重定位（drug repositioning）尚未发现任何可用于对抗COVID-19的新型抗病毒药物。尽管瑞德西韦（remdesivir）已获得美国监管机构的紧急使用授权，但其在临床试验中仅展现出有限的疗效。地塞米松（dexamethasone）属于兼具抗炎与免疫抑制特性的糖皮质激素，可降低接受机械通气或氧疗的重症患者的死亡率。包括单克隆抗体（monoclonal antibody）、干扰素（interferon）、特异性蛋白及抗凝剂（anticoagulant）在内的生物制剂类药物，目前正通过多项临床试验评估其在COVID-19治疗中的应用价值。世界卫生组织（WHO）曾警告称，即便最终研发出疫苗，冠状病毒也可能永远不会被消灭，这凸显了开发创新药物的紧迫性。当前最为现实的防控场景，是开发针对严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）的特异性抗病毒药物，以实现对该疾病安全且有效的治疗。