Turkiye Klinikleri Archives of Lung

.: REVIEW
Güncel Bilgiler Işığında COVID-19 Tedavisi
Current Treatment Strategies of COVID-19
Özge AYDIN GÜÇLÜa, Aslı GÖREK DİLEKTAŞLIa
aBursa Uludağ Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları ABD, Bursa, TÜRKİYE
Turkiye Klinikleri Arch Lung. 2021;20(2):48-56
doi: 10.5336/archlung.2020-79896
Article Language: TR
Full Text
ÖZET
Wuhan Sağlık ve Sağlık Hizmetleri Komitesi (Hubei Eyaleti, Çin), 31 Aralık 2019'da, 8 Aralık'tan itibaren semptomları olan 27 pnömoni vakası olduğunu bildirdi. 7 Ocak 2020'de Çinli yetkililer, salgına neden olan ajanın geçici olarak 'yeni koronavirüs (2019-nCoV)' olarak adlandırılan Coronaviridae virüs ailesinin yeni bir türü olduğunu tespit etti. Dünya Sağlık Örgütü (DSÖ), 30 Ocak 2020'de salgını uluslararası acil durum olarak ilan etti, Mart 2020'de pandemi olarak nitelendirdi. DSÖ tarafından daha önce 2019-nCoV olarak anılmakta iken 11 Şubat 2020'de hastalık, şiddetli akut solunum sendromukoronavirüs-2 olarak isimlendirildi. Avrupa'dan Türkiye'ye dönen bir hastanın test sonucu pozitif çıktıktan sonra hastalığın, 11 Mart 2020'de Türkiye'ye ulaştığı doğrulanmıştır. Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] için en uygun tedavi yaklaşımı hâlen belirsizdir. Mevcut tedavi protokolleri sınırlı verilere dayanmaktadır ve klinik veriler ortaya çıktıkça, hastalığa ve tedaviye yönelik bilgilerimiz hızla gelişmektedir. Randomize kontrollü çalışmalardan, gözlemsel kohortlardan ve vaka serilerinden çok sayıda veri ve yayın, bazıları hakemli dergilerde bazıları ise henüz hakemler tarafından gözden geçirilmemiş makaleler olarak hızla ortaya çıkmaktadır. Türkiye Cumhuriyeti Sağlık Bakanlığı, uzmanlık dernekleri ile birlikte COVID19 yönetimi için bir klinik protokol hazırlama amacı ile Türkiye Pandemi Çalışma Grubu'nu oluşturmuş ve kanıta dayalı güncel bilgiler doğrultusunda tedavi önerilerini düzenlemiştir. Ulusal ve uluslararası rehberlerdeki güncel tedavi önerileri doğrultusunda, COVID-19 tedavisinin özetlenmesi amaçlanmıştır.

Anahtar Kelimeler: COVID-19; pandemi; tedavi
ABSTRACT
On 31 December 2019, the Wuhan Municipal Committee of Health and Healthcare (Hubei Province, China) reported that there were 27 cases of pneumonia of unknown origin with symptoms starting on the 8 December. On 7 January 2020, the Chinese authorities identified that the agent causing the outbreak was a new type of virus of the Coronaviridae family, temporarily called 'new coronavirus, 2019-nCoV'. On January 30th, 2020, the World Health Organisation (WHO) declared the outbreak an international emergency and described it as a pandemic in March 2020. While it was previously referred to as 2019-nCoV by WHO, on February 11, 2020, the disease was named as severe acute respiratory syndrome-coronavirus2. The disease was confirmed to have reached Turkey on 11 March 2020, after a patient who had returned to Turkey from Europe, tested positive. The most appropriate treatment approach to treating COVID-19 remains unclear. Current treatment protocols are based on limited data and are evolving rapidly as clinical data emerge. A large volume of data and publications from randomized controlled trials, observational cohorts, and case series are emerging promptly, some in peer-reviewed journals, others as manuscripts that have not yet been peer reviewed. The Republic of Turkey Ministry of Health invited the specialties societies to prepare a clinical protocol for the management of COVID-19. The Turkish Pandemic Working Group prepare the present recommendations with the evidence available at the time of preparing them. It is aimed to summarize the treatment management of COVID-19 in line with the current treatment recommendations in national and international guidelines.

Keywords: COVID-19; pandemic; treatment
REFERENCES:
  1. Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76:71-6. Erratum in: Int J Surg. 2020;77:217. [Crossref]  [PubMed]  [PMC] 
  2. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi, Bilim Kurulu Çalışması. Ankara; 2020. [Link] 
  3. Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, et al. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020;71(15):732-9. [Crossref]  [PubMed]  [PMC] 
  4. Recovery Randomised Evaluation of COVID-19 Therapy [Internet]. © 2020 Nuffield Department of Population Health [cited 8.6.2020]. No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19. Available from: [Link] 
  5. Tang W, Cao Z, Han M, Wang Z, Chen J, Sun W, et al. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ. 2020;369:m1849. [Crossref]  [PubMed]  [PMC] 
  6. Chen CY, Wang FL, Lin CC. Chronic hydroxychloroquine use associated with QT prolongation and refractory ventricular arrhythmia. Clin Toxicol (Phila). 2006;44(2):173-5. [Crossref]  [PubMed] 
  7. Juurlink DN. Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection. CMAJ. 2020;192(17):E450-3. Erratum in: CMAJ. 2020;192(21):E590. [Crossref]  [PubMed]  [PMC] 
  8. Choy KT, Wong AY, Kaewpreedee P, Sia SF, Chen D, Hui KPY, et al. Remdesivir, lopinavir, emetine, and homoharringtonine inhibit SARS-CoV-2 replication in vitro. Antiviral Res. 2020;178:104786. [Crossref]  [PubMed]  [PMC] 
  9. Mentré F, Taburet AM, Guedj J, Anglaret X, Keïta S, de Lamballerie X, et al. Dose regimen of favipiravir for Ebola virus disease. Lancet Infect Dis. 2015;15(2):150-1. [Crossref]  [PubMed] 
  10. Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, et al. Experimental treatment with favipiravir for COVID-19: an open-label control study. Engineering (Beijing). 2020;6(10):1192-8. [Crossref]  [PubMed]  [PMC] 
  11. Chen C, Zhang Y, Huang J, Yin P, Cheng Z, Wu J, et al. Favipiravir versus arbidol for COVID-19: a randomized clinical trial. medRxiv. 2020. [Crossref] 
  12. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-71. [Crossref]  [PubMed]  [PMC] 
  13. US Food and Drug Administration. Remdesivir letter of EUA (May 01, 2021). Available from: [Link] 
  14. Goldman JD, Lye DCB, Hui DS, Marks KM, Bruno R, Montejano R, et al; GS-US-540-5773 Investigators. Remdesivir for 5 or 10 days in patients with severe Covid-19. N Engl J Med. 2020;383(19):1827-37. [Crossref]  [PubMed]  [PMC] 
  15. Beigel JH, Tomashek KM, Dodd LE. Remdesivir for the treatment of Covid-19 - preliminary report. Reply. N Engl J Med. 2020;383(10):994. [Crossref]  [PubMed] 
  16. Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y, et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2020;395(10236):1569-78. Erratum in: Lancet. 2020;395(10238):1694. [PubMed]  [PMC] 
  17. Pan H, Peto R, Karim QA, Alejandria M, Henao-Restrepo AM, García CH, et al. Repurposed antiviral drugs for COVID-19- interim WHO SOLIDARITY trial results. medRxiv. 2020. [Link] 
  18. Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al.; ACTT-1 Study Group Members. Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. 2020;383(19):1813-26. doi: 10.1056/NEJMoa2007764. Epub 2020 Oct 8. [PubMed]  [PMC] 
  19. Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 critically Ill patients with COVID-19 with convalescent plasma. JAMA. 2020;323(16):1582-9. [Crossref]  [PubMed]  [PMC] 
  20. Li L, Zhang W, Hu Y, Tong X, Zheng S, Yang J, et al. Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. JAMA. 2020;324(5):460-70. Erratum in: JAMA. 2020;324(5):519. [Crossref]  [PubMed]  [PMC] 
  21. Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A. 2020;117(17):9490-6. [Crossref]  [PubMed]  [PMC] 
  22. [Link]  February 11, 2021
  23. Bakanlığı, TC Sağlık. "COVID-19 İmmün (Konvalesan) Plazma Tedarik ve Klinik Kullanım Rehberi." (Cited May 01, 2021)
  24. Sanofi and Regeneron provide update on Kevzara® (sarilumab) Phase 3 U.S. trial in COVID-19 patients, Paris and Tarrytown, N.Y. - July 2, 2020. Erişim linki: [Link] 
  25. Roche [Internet]. © 2021 F. Hoffmann-La Roche Ltd. Roche provides an update on the phase III COVACTA trial of Actemra/RoActemra in hospitalised patients with severe COVID-19 associated pneumonia. Available from: [Link]  (Cited 29 July, 2020)
  26. Tsai A, Diawara O, Nahass RG, Brunetti L. Impact of tocilizumab administration on mortality in severe COVID-19. Sci Rep. 2020;10(1):19131. [Crossref]  [PubMed]  [PMC] 
  27. Stone JH, Frigault MJ, Serling-Boyd NJ, Fernandes AD, Harvey L, Foulkes AS, et al; BACC Bay Tocilizumab Trial Investigators. Efficacy of tocilizumab in patients hospitalized with Covid-19. N Engl J Med. 2020;383(24):2333-44. [Crossref]  [PubMed]  [PMC] 
  28. Hermine O, Mariette X, Tharaux PL, Resche-Rigon M, Porcher R, Ravaud P; CORIMUNO-19 Collaborative Group. Effect of tocilizumab vs usual care in adults hospitalized with COVID-19 and moderate or severe pneumonia: a randomized clinical trial. JAMA Intern Med. 2021;181(1):32-40. [Crossref]  [PubMed]  [PMC] 
  29. Salvarani C, Dolci G, Massari M, Merlo DF, Cavuto S, Savoldi L, et al; RCT-TCZ-COVID-19 Study Group. Effect of tocilizumab vs standard care on clinical worsening in patients hospitalized with COVID-19 pneumonia: a randomized clinical trial. JAMA Intern Med. 2021;181(1):24-31. [Crossref]  [PubMed]  [PMC] 
  30. Malgie J, Schoones JW, Pijls BG. Decreased mortality in COVID-19 patients treated with tocilizumab: a rapid systematic review and meta-analysis of observational studies. Clin Infect Dis. 2020:ciaa1445. [PubMed]  [PMC] 
  31. Gupta S, Wang W, Hayek SS, Chan L, Mathews KS, Melamed ML, et al; STOP-COVID Investigators. Association between early treatment with tocilizumab and mortality among critically Ill patients with COVID-19. JAMA Intern Med. 2021;181(1):41-51. [PubMed]  [PMC] 
  32. Busani S, Bedini A, Biagioni E, Serio L, Tonelli R, Meschiari M, et al; Modena Covid-19 Working Group (MoCo19). Two fatal cases of acute liver failure due to HSV-1 infection in COVID-19 patients following immunomodulatory therapies. Clin Infect Dis. 2020:ciaa1246. [Crossref]  [PubMed]  [PMC] 
  33. Luo P, Liu Y, Qiu L, Liu X, Liu D, Li J. Tocilizumab treatment in COVID-19: a single center experience. J Med Virol. 2020;92(7):814-8. [Crossref]  [PubMed]  [PMC] 
  34. Sciascia S, Aprà F, Baffa A, Baldovino S, Boaro D, Boero R, et al. Pilot prospective open, single-arm multicentre study on off-label use of tocilizumab in patients with severe COVID-19. Clin Exp Rheumatol. 2020;38(3):529-32. [PubMed] 
  35. Lee DW, Gardner R, Porter DL, Louis CU, Ahmed N, Jensen M, et al. Current concepts in the diagnosis and management of cytokine release syndrome. Blood. 2014;124(2):188-95. Erratum in: Blood. 2015;126(8):1048. Dosage error in article text. Erratum in: Blood. 2016;128(11):1533. [Crossref]  [PubMed]  [PMC] 
  36. Maude SL, Barrett D, Teachey DT, Grupp SA. Managing cytokine release syndrome associated with novel T cell-engaging therapies. Cancer J. 2014;20(2):119-22. [Crossref]  [PubMed]  [PMC] 
  37. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ; HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4. [Crossref]  [PubMed]  [PMC] 
  38. Cavalli G, De Luca G, Campochiaro C, Della-Torre E, Ripa M, Canetti D, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020;2(6):e325-31. [Crossref]  [PubMed]  [PMC] 
  39. Xie Y, Cao S, Dong H, Li Q, Chen E, Zhang W, et al. Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19. J Infect. 2020;81(2):318-56. [Crossref]  [PubMed]  [PMC] 
  40. WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group; Sterne JAC, Murthy S, Diaz JV, Slutsky AS, Villar J, Angus DC, et al. Association between administration of systemic corticosteroids and mortality among critically Ill patients with COVID-19: a meta-analysis. JAMA. 2020;324(13):1330-41. [Crossref]  [PubMed]  [PMC] 
  41. Siemieniuk RA, Bartoszko JJ, Ge L, Zeraatkar D, Izcovich A, Kum E, et al. Drug treatments for covid-19: living systematic review and network meta-analysis. BMJ. 2020;370:m2980. Update in: BMJ. 2020;370:m3536. Update in: BMJ. 2020;371:m4852. [PubMed]  [PMC] 
  42. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC, et al. Infectious diseases Society of America Guidelines on the treatment and management of patients with COVID-19. Clin Infect Dis. 2020:ciaa478. [Crossref]  [PubMed]  [PMC] 
  43. RECOVERY Collaborative Group; Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, et al. Dexamethasone in hospitalized patients with Covid-19 - preliminary report. N Engl J Med. 2020:NEJMoa2021436. [PubMed]  [PMC] 
  44. McCreary EK, Pogue JM. Coronavirus disease 2019 treatment: a review of early and emerging options. Open Forum Infect Dis. 2020;7(4):ofaa105. [Crossref]  [PubMed]  [PMC] 

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30.03.2014

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