更新的 COVID-19 不同疾病(如癌症)的药物疗法

Z. Tolou_Ghamari
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引用次数: 0

摘要

研究表明,癌症是影响预期寿命的主要并发症,也是全球死亡的首要原因。截至 2024 年 2 月 21 日,全球 COVID-19 感染病例达 703 525 337 例,死亡 6 984 801 例,为治疗这些病例,必须对癌症等不同疾病进行精心设计的药物治疗管理。本调查旨在回顾目前针对不同疾病、癌症和 COVID-19 患者的可获得的药物治疗。相关研究包括综述文章、临床试验和病例报告(n=109 篇文章)。现有常规抗肿瘤治疗的结果可能是争论的基础。在普通人群中,建议鼻咽部拭子阳性的无症状患者接受抗生素预防,对于有症状体征的患者,应考虑在抗高血压治疗的基础上调整血管紧张素转换酶。此外,还可以推荐使用法非比拉韦、氯喹和羟氯喹,但要注意多种药物之间的相互作用。对于中度患者,建议使用羟氯喹或氯喹/阿奇霉素。对于呼吸衰竭患者,建议使用康复血浆。对于症状发展为细胞因子风暴的人群,建议使用白细胞介素-6(IL-6)拮抗剂。由于抗癌药物可能会导致免疫抑制,而 COVID-19 又会导致肺功能恶化,因此对于药物治疗策略的管理建议,进一步的循证研究似乎是有益的。
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Updated COVID-19 Pharmacotherapy in Different Diseases Such as Cancer
Studies suggest that cancer is a main complication regarding life expectancy and a foremost reason for death worldwide. For the treatment of COVID-19 infected 703,525,337 cases with 6,984,801 deaths worldwide up to February 21, 2024, well-designed pharmacotherapy management in different diseases, such as cancer, is respected. This investigation aims to review the current accessible medical treatment for patients with different diseases, cancer, and COVID-19. The appropriate documents for this review were achieved by searching databases such as Web of Science, Scopus, and PUBMED. Relevant studies included in review articles, clinical trials, and case reports that were evaluated and used (n=109 articles). In those with cancer and COVID-19, publications reported worsened clinical conditions with a considerably higher risk of death. The result of existing regular antitumor management could be a basis of debate. In the general population, asymptomatic patients with positive nasopharyngeal swabs are recommended to receive antibiotic prophylaxis, and in those with symptomatic signs, adjustment of angiotensin-converting enzyme based on anti-hypertensive therapy should be considered. In patients with liver disease, nitazoxanide plus sofosbuvir, ivermectin, tocilizumab, convalescent plasma, and low molecular weight heparin in certain situations is recommended. Furthermore, favipiravir, chloroquine, and hydroxychloroquine could also be recommended, but with caution regarding to polypharmacy interactions. For those with moderate disease, hydroxychloroquine or chloroquine/ azithromycin was recommended. In the patients with respiratory failure, convalescent plasma was suggested. In the populations where those symptoms progress to the sign of a cytokine storm, the antagonists of interleukin-6 (IL-6) were suggested. To reduce fever, however, ibuprofen showed more potent efficacy compared to acetaminophen, but it may delay the benefits of a fever response. Owing to the immune suppression that could be caused by anti-cancer drugs and deterioration of lung functions due to COVID-19, for proposed management regarding pharmacotherapy strategies, further evidence-based studies seem to be advantageous.
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