Oral antivirals for the prevention and treatment of SARS-CoV-2 infection.
Oral antivirals for the prevention and treatment of SARS-CoV-2 infection.
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DOI：
10.24875/aidsrev.22000001
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发表时间：
2022-03-01
期刊：
影响因子：
2.2
通讯作者：
Gendelman, Howard E.
中科院分区：
文献类型：
--
作者：
Soriano, Vicente;de-Mendoza, Carmen;Edagwa, Benson;Trevino, Ana;Barreiro, Pablo;Fernandez-Montero, Jose, V;Gendelman, Howard E.
关键词：
疫苗和抗病毒药物是用于遏制、预防和治疗危及生命的病毒性疾病的经典武器。具体而言，对于SARS-CoV-2感染，疫苗可预防严重的COVID-19疾病表现和并发症。然而，免疫力下降和疫苗逃逸突变体的出现仍然是一个日益严重的威胁。目前omicron COVID-19变种的激增凸显了这一点。因此，存在着寻找替代治疗的竞赛。我们认为，口服小分子抗病毒药物，阻止SARS-CoV-2感染是必不可少的。与目前可用的单克隆抗体和Remdesivir相比，需要胃肠外给药，口服抗病毒药物在门诊环境中提供治疗，并在更大范围内传播。为了应对2021年底的这一需求，监管机构为莫努匹拉韦和Nirmatrelvir提供了紧急使用授权。这些药物分别作用于病毒聚合酶和蛋白酶。每种药物给药5天，可以分别减少30%和89%的疾病进展。更多口服抗病毒药物的出现、联合疗法的评估、缓释药物的配方及其对早期治疗和预防的益处可能会改变COVID-19大流行的格局。
Vaccines and antivirals are the classical weapons deployed to contain, prevent, and treat life-threatening viral illnesses. Specifically, for SARS-CoV-2 infection, vaccines protect against severe COVID-19 disease manifestations and complications. However, waning immunity and emergence of vaccine escape mutants remains a growing threat. This is highlighted by the current surge of the omicron COVID-19 variant. Thus, there is a race to find treatment alternatives. We contend that oral small molecule antivirals that halt SARS-CoV-2 infection are essential. Compared to currently available monoclonal antibodies and remdesivir, where parenteral administration is required, oral antivirals offer treatments in an outpatient setting with dissemination available on a larger scale. In response to this need at 2021’s end, regulatory agencies provided emergency use authorization for both molnupiravir and nirmatrelvir. These medicines act on the viral polymerase and protease, respectively. Each is given for 5 days and can reduce disease progression by 30% and 89%, respectively. The advent of additional oral antivirals, the assessment of combination therapies, the formulation of extended-release medications, and their benefit for both early treatment and prophylaxis will likely transform the landscape of the COVID-19 pandemic.