COVID-19 — нова вірусна інфекція: патогенез, діагностика, лікування
DOI:
https://doi.org/10.30978/TB2020-2-7Ключові слова:
коронавірус, COVID-19, патогенез, діагностика, лікуванняАнотація
Під час пандемії нової коронавірусної інфекції SARSCoV2 з’являється багато нових даних щодо особливостей інфекції та ведення хворих на COVID19. У роботі представлено огляд даних, оприлюднених у літературних джерелах на початок травня 2020 р., стосовно патогенезу захворювання, клінічного перебігу, діагностики, а також світовий досвід лікування таких хворих. Більшість даних є попередніми, які представлено у відомих виданнях у відкритому доступі, зокрема досвід зарубіжних лікарів — китайських, російських, американських, британських та інших. Багато з них опубліковано в Інтернеті до офіційного видання. Описано основні уявлення про механізми проникнення вірусу в організм людини (через рецептори АПФ2, CD147, гемоглобін), патогенез захворювання (з розвитком «цитокінового шторму», ознаками руйнування лімфоцитів, зниженням кількості CD4+ та CD8+ Тлімфоцитів у крові), ознаки тяжкого перебігу інфекції, основні клінічні характеристики COVID19, пов’язані з патогенезом (гострий респіраторний дистрессиндром, синдром позалегеневого системного гіперзапалення з клінічною картиною васкуліту з гіперкоагуляцією та пошкодженням багатьох органів). Коротко описано основні підходи до діагностики, недоліки діагностичних методів (з чутливістю ПЛРметодів 50—79 %, строки використання тестів на імуноглобуліни). Також охарактеризовано основні медикаментозні методи терапії, які використовують і розробляють. Представлено коротке описання актуальних противірусних (препарати на основі хлорохіну, лопінавір/ритонавір, фавіпіравір, ремдезивір, інтерферони, переливання плазми), протизапальних (моноклональні антитіла, кортикостероїди) засобів, їхні можливі побічні ефекти, ефективність та перспективи використання.
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