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Covid-19 pandemic: Perspectives on management
Journal of Reproductive Immunology ( IF 2.9 ) Pub Date : 2021-06-05 , DOI: 10.1016/j.jri.2021.103344
Premjith Gathiram 1 , Jagidesa Moodley 2 , Olive P Khaliq 2
Affiliation  

The pandemic COVID-19 presents a major challenge to identify effective drugs for treatment. Clinicians need evidence based on randomized trials regarding effective medical treatments for this infection. Currently no effective therapies exist for the progression of the mild forms to severe disease. Knowledge however is rapidly expanding. Remdesivir, an anti- retroviral agent has in vitro activity against this virus and has shown to decrease the duration of ICU care in patients with severe disease, while low dose dexamethasone also showed a decrease in the duration of stay in cases of severe disease requiring assisted ventilation. At the time of writing this article, two mRNA-based vaccines have shown an approximate 95 % efficacy in preventing infection in large clinical trials. At least one of these drugs has regulatory permission for vaccination in high-income countries. Low and middle-income countries may have difficulties in initiating vaccine programs on large scales because of availability, costs, refrigeration and dissemination. Adequately powered randomized trials are required for drugs with in vitro activity against the virus. Supportive care should be provided for stable, hypoxia and pneumonia free patients on imaging. Vaccines are of obvious benefit and given the preliminary evidence of the efficacy of over 95 %, Low and middle-income countries must develop links with the WHO COVAX program to ensure global distribution of vaccines.



中文翻译:

Covid-19 大流行:对管理的看法

大流行性 COVID-19 对确定有效的治疗药物提出了重大挑战。临床医生需要基于关于对这种感染进行有效药物治疗的随机试验的证据。目前还没有针对轻度疾病向重度疾病进展的有效疗法。然而,知识正在迅速扩展。抗逆转录病毒药物瑞德西韦对这种病毒具有体外活性,并已显示可缩短重症患者的 ICU 护理时间,而低剂量地塞米松也可缩短需要辅助治疗的重症患者的住院时间通风。在撰写本文时,两种基于 mRNA 的疫苗在大型临床试验中显示出大约 95% 的预防感染功效。这些药物中至少有一种在高收入国家获得了疫苗接种的监管许可。由于可用性、成本、冷藏和传播,低收入和中等收入国家可能难以启动大规模疫苗计划。对于具有体外抗病毒活性的药物,需要进行充分有力的随机试验。应为影像学上稳定、缺氧和无肺炎的患者提供支持治疗。疫苗具有明显的益处,鉴于初步证据表明其有效性超过 95%,低收入和中等收入国家必须与 WHO COVAX 计划建立联系,以确保疫苗的全球分发。冷藏和传播。对于具有体外抗病毒活性的药物,需要进行充分有力的随机试验。应为影像学上稳定、缺氧和无肺炎的患者提供支持治疗。疫苗具有明显的益处,鉴于初步证据表明其有效性超过 95%,低收入和中等收入国家必须与 WHO COVAX 计划建立联系,以确保疫苗的全球分发。冷藏和传播。对于具有体外抗病毒活性的药物,需要进行充分有力的随机试验。应为影像学上稳定、缺氧和无肺炎的患者提供支持治疗。疫苗具有明显的益处,鉴于初步证据表明其有效性超过 95%,低收入和中等收入国家必须与 WHO COVAX 计划建立联系,以确保疫苗的全球分发。

更新日期:2021-06-17
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