ABSTRACT

Introduction

Mediators of immunity and inflammation are playing a crucial role in COVID-19 pathogenesis and complications as demonstrated by several genetic and clinical studies. Thus, repurposing of drugs that possess anti-inflammatory and/or immune-modulatory effects for COVID-19 is considered a rational approach.

Areas covered

We analyze selected studies that correlated COVID-19 with dysregulated interferon and inflammatory responses while reflecting on our academic and real-life experience using non-steroidal anti-inflammatory drugs, nitazoxanide and azithromycin for management of COVID-19. Moreover, we interpret the results that suggested a potential survival benefit of low-dose aspirin and colchicine when used for COVID-19.

Expert opinion

Nitazoxanide/azithromycin combination has been first hypothesized by the author and practiced by him and several researchers to benefit COVID-19 patients due to a potential ability to augment the natural interferon response as well as their positive immunomodulatory effects on several cytokines. Furthermore, NSAIDs, that are unfortunately currently at best of second choice after paracetamol, have been early postulated and clinically practiced by the author to prevent or ameliorate COVID-19 complications and mortality due to their anti-inflammatory and immunomodulatory properties. Finally, we repeat our previous call to adopt our observational study that used these drugs in sufficiently powered double blind randomized clinical trials.

中文翻译：

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NSAIDs/硝唑尼特/阿奇霉素重新用于治疗 COVID-19：通过免疫调节作用可能减轻细胞因子风暴白细胞介素 6 放大器

 抽象的

 介绍

多项遗传和临床研究表明，免疫和炎症介质在 COVID-19 发病机制和并发症中发挥着至关重要的作用。因此，重新利用具有抗炎和/或免疫调节作用的 COVID-19 药物被认为是一种合理的方法。

 覆盖领域

我们分析了将 COVID-19 与干扰素失调和炎症反应相关的选定研究，同时反思了我们使用非甾体抗炎药、硝唑尼特和阿奇霉素治疗 COVID-19 的学术和现实生活经验。此外，我们对结果进行了解释，这些结果表明低剂量阿司匹林和秋水仙碱用于治疗 COVID-19 时具有潜在的生存益处。

 专家意见

硝唑尼特/阿奇霉素组合是作者首先提出的假设，并由他和几位研究人员实践，由于具有增强自然干扰素反应的潜在能力以及对多种细胞因子的积极免疫调节作用，使 COVID-19 患者受益。此外，不幸的是，非甾体抗炎药目前最多是扑热息痛之后的第二选择，作者很早就提出并在临床实践中使用它来预防或改善 COVID-19 并发症和死亡率，因为它们具有抗炎和免疫调节特性。最后，我们重申之前的呼吁，即采用我们的观察性研究，该研究在足够有力的双盲随机临床试验中使用了这些药物。