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코로나19 약물치료의 최신지견
Current advances in pharmacological treatments for patients with COVID-19

대한의사협회지 2021년 64권 5호 p.375 ~ p.385

김선빈(Kim Sun-Bean) - Korea University College of Medicine Department of Internal Medicine Division of Infectious Diseases
염준섭(Yeom Joon-Sup) - Yonsei University College of Medicine Department of Internal Medicine

Abstract

Since the coronavirus disease 2019 (COVID-19) outbreak, more than 150 million people in over 200 countries have been infected, with over 3 million people dying due to it, as of May 1, 2021. Many researchers are working continuously to find effective drug treatments for COVID-19; however, the optimal treatment approach remains unclear. In this article, current advances in pharmacological treatments for patients with COVID-19 are discussed. Data obtained from recent studies indicate a mortality benefit with the administration of dexamethasone or adjunctive tocilizumab and potential clinical benefits with remdesivir (with or without baricitinib). Several monoclonal antibodies against severe acute respiratory syndrome coronavirus 2 have been developed. The US Food and Drug Administration issued two emergency use authorizations: one for bamlanivimab/etesevimab and another for casirivimab/imdevimab for patients with mild to moderate COVID-19, at high risk of progression to severe disease and/or hospitalization. The pathogenesis of COVID-19 indicates that antiviral treatments would be most beneficial in the early phase of the infection that is primarily driven by replication of severe acute respiratory syndrome coronavirus 2, whereas immunosuppressive/anti-inflammatory therapies are likely to be more beneficial during the late phase of the infection, when the disease is driven by an exaggerated immune/inflammatory response to the virus that causes tissue damage.

키워드

코로나19, 코로나바이러스감염, 치료, 항바이러스제, 면역조절제, 단일항체

COVID-19, Coronavirus infections, Antiviral agents, Immunomodulators, Monoclonal antibodies

KMID : 0614720210640050375 dx.doi.org/10.5124/jkma.2021.64.5.375

원문 및 링크아웃 정보

학회

등재저널 정보

주제코드

주제명(Target field)

연구대상(Population)

연구참여(Sample size)

대상성별(Gender)

질병특성(Condition Category)

연구환경(Setting)

연구설계(Study Design)

연구기간(Period)

중재방법(Intervention Type)

중재명칭(Intervention Name)

키워드(Keyword)

유효성결과(Recomendation)

항바이러스제인 렘데시비르는 현재 미국 식품의약국에서 코로나19 치료제로 승인한 유일한 약물로, 산소치료가 필요하지만 인공호흡기 또는 체외막산소공급을 사용하지 않는 코로나19 환자에게 렘데시비르를 투여해 볼 수 있다. 최근 세계보건기구에서는 SOLIDARITY 연구 결과에 따라 코로나19 치료에 있어 중증도와 관계없이 렘데시비르 투여를 조건부로 권고 반대를 하였으나, 기존 연구들에서 병원 내 사망위험을 낮출 수 없을지라도 생존자의 회복 및 입원기간을 낮추었기 때문에 현재 대규모로 진행 중인 SOLIDARITY 연구의 최종 결과를 확인해보는 것이 필요할 것으로 생각된다. 덱사메타손은 산소치료가 필요한 입원 환자의 생존율을 향상시키는 것으로 밝혀졌으며, 인공호흡기 치료가 필요한 환자에서 가장 큰 효과가 확인되어 중증 환자에서의 치료제로 고려해볼 수 있다.

연구비지원(Fund Source)

근거수준평가(Evidence Hierarchy)

출판년도(Year)

참여저자수(Authors)

대표저자

DOI

dx.doi.org/10.5124/jkma.2021.64.5.375

KCD코드

ICD 03

건강보험코드

코로나19 약물치료의 최신지견 Current advances in pharmacological treatments for patients with COVID-19

Abstract

키워드

코로나19 약물치료의 최신지견
Current advances in pharmacological treatments for patients with COVID-19