Immunosuppressive Drugs and COVID-19: A Review
| العنوان: | Immunosuppressive Drugs and COVID-19: A Review |
|---|---|
| المؤلفون: | Tessa S. Schoot, Angèle P. M. Kerckhoffs, Luuk B. Hilbrands, Rob J. van Marum |
| المصدر: | Frontiers in Pharmacology, Vol 11 (2020) Frontiers in Pharmacology, 11 Frontiers in Pharmacology Schoot, T S, Kerckhoffs, A P M, Hilbrands, L B & van Marum, R J 2020, ' Immunosuppressive Drugs and COVID-19: A Review ', Frontiers in Pharmacology, vol. 11, 1333 . https://doi.org/10.3389/fphar.2020.01333Test |
| بيانات النشر: | Frontiers Media SA, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | 0301 basic medicine, mTOR inhibitors, ARDS, Middle East respiratory syndrome coronavirus, viruses, coronavirus, immunosuppressive drugs, Review, medicine.disease_cause, corticosteroids, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Tocilizumab, Randomized controlled trial, law, medicine, Pharmacology (medical), Coronavirus, Pharmacology, Thiopurine methyltransferase, biology, SARS-CoV-2, business.industry, lcsh:RM1-950, COVID-19, virus diseases, medicine.disease, calcineurin inhibitors, Clinical trial, lcsh:Therapeutics. Pharmacology, 030104 developmental biology, chemistry, 030220 oncology & carcinogenesis, Immunology, biology.protein, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], Cytokine storm, business, mycophenolic acid |
| الوصف: | Contains fulltext : 225456.pdf (Publisher’s version ) (Open Access) BACKGROUND: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is currently unknown whether immunosuppressive drugs are advantageous or detrimental in patients with COVID-19. Immunosuppressive drugs could be harmful in the initial phase of COVID-19. In this phase, the host immune response is necessary to inhibit viral replication. However, immunosuppressive drugs might have a beneficial effect in the later, more severe phase of COVID-19. In this phase, an overshoot of the host immune response (the "cytokine storm") can cause ARDS, multiorgan failure and mortality. AIM: To summarize the available evidence on the effect of immunosuppressive drugs on infection with SARS-CoV-2. The effects of immunosuppressive drugs on similar pandemic coronaviruses may resemble the effects on SARS-CoV-2. Thus, we also included studies on the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). METHODS: The study protocol was registered in PROSPERO (registration number CRD42020181137). We included randomized controlled trials (RCTs), cohort studies with a control group and case-control studies concerning humans ≥ 18 years old. We also included in-vitro studies and animal studies with a control group. RESULTS AND CONCLUSION: Sixty-nine studies were included. Interestingly, MPA inhibits SARS-CoV-2 replication in-vitro. Clinical studies are needed to confirm the inhibitory effect of MPA on SARS-CoV-2 replication in-vivo. There are indications that corticosteroids and IL-6 inhibitors, like tocilizumab, can reduce mortality and prevent mechanical ventilation in patients with COVID-19. However, observational studies have contradictory results and the risk of bias is high. Thus, these results have to be confirmed in high-quality clinical trials before these drugs can be implemented as standard care. Based on the positive results of CNIs, mTOR inhibitors and thiopurine analogues in in-vitro studies with SARS-CoV and MERS-CoV, it would be interesting to investigate their effects on SARS-CoV-2 replication. |
| وصف الملف: | application/pdf |
| تدمد: | 1663-9812 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fe79b72c24b0376057e039c11926680dTest https://doi.org/10.3389/fphar.2020.01333Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....fe79b72c24b0376057e039c11926680d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16639812 |
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