بررسي اثربخشي داروهاي مختلف در درمان COVID-19

Evaluation of the effectiveness of various drugs in the treatment of COVID-19

در دسامبر 2019 شيوع نوع جديدي از بيماري حاد تنفسي (پنوموني) ويروسي در مركز چين گزارش گرديده و تعداد افراد مبتلا به آن نيز به‌سرعت افزايش يافت. پزشكان اين بيماري را COVID-19 نام‌گذاري كرده و منشاء آن­را ويروسي با نام SARS-COV-2 معرفي نمودند. تاكنون داروي مؤثري كه بتواند به قطعيت جهت درمان اين بيماري به­ كار گرفته شود توليد نشده است اما برخي داروها شناخته و معرفي شدند كه تأثير چشمگيري در ايجاد بهبودي بيماران نشان دادند. هدف از اين مطالعه ارزيابي و تجزيه و تحليل داروهايي است كه تاكنون براي درمان مبتلايان به Covid 19 مورد استفاده قرار گرفتند تا بتوان داروهايي كه بيش­ترين تأثير بر روي بهبودي مبتلايان را داشته شناسايي و معرفي گردند. در اين مطالعه مروري مقالات چاپ شده متعددي در زمينه بررسي ساختار، ويژگي­ ها، منشاء و شيوع ويروس عامل بيماري COVID-19 از سايت­ هاي معتبر Pubmed , Google scholar ,Scopus با كليد واژه­هايي نظير " COVID-19" و "Coronavirus 2019" و " COVID-19 and drug s " جمع آوري گرديده است. داروي لوپيناوير و ريتوناوير در همراهي با داروهاي مكمل مثل اينترفرون آلفا در كاهش ظرفيت بار خانواده Betacoronaviruses مؤثر بوده است. داروهاي هيدروكسي كلروكين و كلروكين در محدود كردن تكثير COVID-19 در شرايط آزمايشگاهي اثر بخش بوده است. داروي ضد ويروسي آمانتادين سبب كاهش ظرفيت تكثير ويروس مي­ گردد. داروي Remdesivir مي ­تواند از آسيب وارده به ريه انسان در اثر عفونت ويروس كرونا ممانعت به­ عمل آورد. در رابطه با داروي فاويپيراوير مطالعه­ ها نرخ بهبودي 43/91 درصدي را نشان دادند كه حاكي از اثربخشي بسيار بالاي اين دارو است. فاويپيراوير و رمديسيور اثربخشي چشمگيري را نشان دادند. داروهاي لوپيناوير و ريتوناوير كه همراه با داروهاي مكملي اينترفرون آلفا استفاده شده­اند و نيز داروي هيدروكسي­كلروكين و كلروكين، اثر بخشي پاييني را نشان داده ­اند.

In December 2019, the outbreak of a new type of acute viral respiratory disease (pneumonia) was reported in central China and the number of people infected with it increased rapidly. Specialists named the disease COVID-19 and identified its origin as a virus called SARS-CoV-2. So far, no effective drug has been developed that can be used to definitively treat this disease, but some drugs have been identified and introduced that have shown a significant impact on the recovery of patients. In this review study, several published articles on the structure, characteristics, origin and prevalence of COVID-19 virus, as well as drugs used to inhibit COVID-19 virus, were reviewed. All the documents and articles have been collected from reputable sites PubMed, Google scholar, Scopus with keywords such as "COVID-19", "Coronavirus 2019" and "COVID-19 and drugs". Among the drugs studied in this study, lupinavir and ritonavir have been clinically evaluated in many cases along with complementary drugs such as Interferon Alfa, and the results indicate the effectiveness of this drug in reducing the load capacity of the Betacoronaviruses family. Hydroxychloroquine and chloroquine have been shown to be effective in limiting the replication of COVID-19 in vitro. The antiviral drug amantadine reduces the virus' replication capacity due to its disruption of the lysosomal pathway. Amantadine, as an anti-influenza drug, prevents the virus from uncoating and releasing its nucleic acid into the respiratory epithelial cells. Remdesivir can also prevent damage to the human lungs caused by coronavirus infection. In relation to favipiravir, studies showed a recovery rate of 91.43%, which indicates a very high effectiveness of this drug. Among the studied drugs, favipiravir and remediator have shown significant effectiveness in many cases and are even recognized and used as COVID-19 effective drug in some countries, so that the efficacy of favipiravir has been reported to be 91.43%. Lupinavir and ritonavir, which have been used in combination with supplements such as Interferon Alpha, as well as hydroxychloroquine and chloroquine, which reduce the load capacity of the virus, have been shown to be less effective.