Aralık 2019'da Çin'in Wuhan şehrinde tanımlanan ve hızla yayılan SARS-CoV-2 virüsü, küresel bir pandemiye yol açmıştır. T.C. Sağlık Bakanlığının önerdiği mevcut tedavi protokolündeki ilaçlar (hidroksiklorokin, azitromisin, lopinavir/ritonavir, favipiravir, tocilizumab) da dâhil olmak üzere, COVID-19 hastalığının tedavisi için henüz kanıtlanmış bir ilaç yoktur. Bununla birlikte, pek çok molekülün in vitro veya klinik çalışmalarla etkinliği araştırılmaktadır. Arbidol, ribavirin, niklozamit, nitazoksanid, ivermektin gibi antiviral aktivitesi olan ilaçların, COVID-19 hastalarındaki etkinliğini değerlendirecek klinik çalışmalar başlamıştır. Ayrıca immünomodülatör ve antiinflamatuar etkileri nedeniyle Tip 1 interferonlar, kortikosteroidler, ekulizumab, sirolimus, bevacizumab, Janus kinaz inhibitörleri, statinler ve kolşisin gibi pek çok ilacın, sitokin fırtınasına bağlı olarak özellikle kritik COVID-19 hastalarında gelişen akut akciğer hasarı ve akut respiratuar distres sendromundaki etkinliği araştırılmaktadır. Bu derlemede, yukarıda bahsedilen ilaçlar ve mezenkimal kök hücre tedavisinin etkinliğinin değerlendirildiği in vitro ve klinik çalışmalar ele alınmıştır. Klinisyenler, bu çalışmaları yakından takip etmeli ve çalışmaların sonuçlarına göre mevcut tedavilerin güncellenebileceğini göz önünde bulundurmalıdırlar.
Anahtar Kelimeler: COVID-19; antiviral ilaçlar; immünomodülatör ilaçlar; klinik çalışmalar; kök hücre tedavisi; SARS-CoV-2
The SARS-CoV-2 virus, which is identified in Wuhan, China in December 2019 and spread rapidly, caused a global pandemic. There is currently no proven drug for the treatment of COVID19 disease, including drugs (hydroxychloroquine, azithromycin, lopinavir/ritonavir, favipiravir, tocilizumab) in the current treatment protocol recommended by the Republic of Turkey Ministry of Health. However, the effectiveness of many molecules is being investigated by in vitro or clinical studies. Clinical trials have started to evaluate the effectiveness of drugs with antiviral activity such as arbidol, ribavirin, niklozamid, nitazoxanide, ivermectin in COVID-19 patients. In addition, treatment efficacy of type 1 interferons, corticosteroids, eculizumab, sirolimus, bevacizumab, Janus kinase inhibitors, statins and colchicine in acute lung injury and acute respiratory distress syndrome due to cytokine storm in COVID-19 patients is being investigated with clinical trials. In this review, in vitro and clinical studies evaluating the effectiveness of the above mentioned drugs and mesenchymal stem cell therapy are discussed. Clinicians should follow these studies closely and consider that existing treatments can be updated according to the results of the studies.
Keywords: COVID-19; antiviral drugs; immunomodulator drugs;clinical trials; stem cell therapy; SARS-CoV-2
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