COVID-19比艾滋病晚了40年——有什么教训吗?

IF 1.9 4区 医学 Q4 IMMUNOLOGY AIDS reviews Pub Date : 2020-07-08 DOI:10.24875/AIDSRev.M20000030
Vicente Soriano, Pablo Barreiro, José Manuel Ramos, José M Eirós, Carmen de Mendoza
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引用次数: 3

摘要

由严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)引起的大流行以前所未有的方式打击了卫生保健系统和社会。1981年,报告了第一批艾滋病病例,广泛的诊断测试有助于确定高危群体的特征和这一流行病的全球负担。随着冠状病毒病(COVID -19)的发生,一切都发生得太快了,病例和死亡人数都很大,但在大多数地方仍然不确定。需要迅速扩大对活跃和过去的SARS-CoV-2感染的诊断检测,理想情况下使用快速检测。COVID-19的死亡高度集中在老年人群中,很大一部分死亡是由于“感染”而不是“感染”SARS-CoV-2。它们往往是由于需求过大而导致的卫生保健不足造成的。迄今为止,还没有针对SARS-CoV-2感染的特异性治疗方法。几种抗病毒药物正在进行临床试验,包括目前最有希望的瑞德西韦。对于其他药物,如洛匹那韦/利托那韦,没有显示出显著的病毒学和临床益处。鉴于特征性的肺细胞因子风暴是COVID-19重症肺炎和急性呼吸窘迫的致病机制,抗炎药物正在研究中。皮质类固醇、羟氯喹等药物的疗效有限。针对不同促炎细胞因子的单克隆抗体,如抗白细胞介素6药物tocilizumab,正在进行试验,并取得了令人鼓舞的结果。最终,保护性疫苗将是控制COVID-19大流行的最佳对策。
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COVID-19 Comes 40 Years After AIDS - Any Lesson?

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has hit health-care systems and societies in an unprecedented manner. In 1981, the first cases of AIDS were reported and wide diagnostic testing helped to characterize high-risk groups and the global burden of the epidemic. With Coronavirus Disease (COVID)-19, everything has happened too fast and both cases and fatalities are huge but still uncertain in most places. Diagnostic testing of active and past SARS-CoV-2 infections needs to expand rapidly, ideally using rapid tests. COVID-19 deaths are highly concentrated in the elderly population, with a large proportion of fatalities being "with" rather than "by" SARS-CoV-2 infection. They are often the result of inadequate health care due to overwhelming demands. To date, there is no specific therapy for SARS-CoV-2 infection. Several antivirals are being tested clinically, including remdesivir, at this time the most promising. For others such as lopinavir/ritonavir, neither significant virological nor clinical benefit has been shown. Given the characteristic pulmonary cytokine storm underlying the pathogenic mechanism of severe COVID-19 pneumonia and acute respiratory distress, antiinflammatory agents are being investigated. The benefit of orticosteroids, hydroxychloroquine, etc., is limited. Monoclonal antibodies targeting different pro-inflammatory cytokines, such as tocilizumab, an anti-interleukin 6 agent, are being tried with encouraging results. Ultimately a protective vaccine will be the best response for controlling the COVID-19 pandemic.

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来源期刊
AIDS reviews
AIDS reviews 医学-传染病学
CiteScore
3.40
自引率
4.50%
发文量
41
审稿时长
>12 weeks
期刊介绍: AIDS Reviews publishes papers reporting original scientific, clinical, epidemiologic and social research which contribute to the overall knowledge of the field of the acquired immunodeficiency syndrome and human retrovirology. Currently, the Journal publishes review articles (usually by invitation, but spontaneous submitted articles will also be considered). Manuscripts submitted to AIDS Reviews will be accepted on the understanding that the authors have not submitted the paper to another journal or published the material elsewhere.
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