ABSTRACT

Introduction

SARS-CoV-2 is a novel virus that causes coronavirus disease-19 (COVID-19). Antiviral and immunomodulatory agents have been proposed as potential treatments. Azithromycin exhibits both properties and therefore may play a role.

Areas covered

This article reviews the pharmacology, pharmacokinetics, clinical efficacy, and safety of azithromycin in viral infections, with emphasis on COVID-19. A literature search of PUBMED was conducted on May 30^th and updated on July 28^th.

Expert opinion

Azithromycin presents in vitro activity against SARS-CoV-2 and could act in different points of the viral cycle. Its immunomodulatory properties include the ability to downregulate cytokine production, maintain epithelial cell integrity or prevent lung fibrosis. Azithromycin use was associated with a reduction in mortality and ventilation days in other viral infections. These properties could be beneficial throughout the COVID-19. However, the evidence of its use is scarce and of low quality. Azithromycin has been assessed in retrospective observational studies mainly in combination with hydroxychloroquine, which has shown to provide no benefit. This macrolide presents a well-known safety profile. Upcoming clinical trials will determine the role of azithromycin in the COVID-19 (including the stage of the disease where it offers the greatest benefits and the effect of its combination with other drugs).

中文翻译：

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阿奇霉素治疗COVID-19的研究进展

摘要

介绍

SARS-CoV-2是一种新型病毒，可​​导致冠状病毒病19（COVID-19）。已经提出了抗病毒和免疫调节剂作为潜在的治疗方法。阿奇霉素具有两种特性，因此可能发挥作用。

覆盖区域

本文综述了阿奇霉素在病毒感染中的药理学，药代动力学，临床疗效和安全性，重点是COVID-19。5月30^日进行了PUBMED的文献检索，并于7月28^日更新了文献。

专家意见

阿奇霉素在体外对SARS-CoV-2具有抗性，可以在病毒周期的不同阶段起作用。它的免疫调节特性包括下调细胞因子产生，维持上皮细胞完整性或预防肺纤维化的能力。使用阿奇霉素可降低其他病毒感染的死亡率和通气天数。这些特性在整个COVID-19中可能都是有益的。但是，其使用的证据很少且质量低下。在回顾性观察研究中已对阿奇霉素进行了评估，主要是与羟氯喹联用，已证明没有益处。该大环内酯类药物具有众所周知的安全性。