Antiviral combination treatment strategies for SARS-CoV-2 infection in immunocompromised patients.

IF 3.6 3区医学 Q2 INFECTIOUS DISEASES

Current Opinion in Infectious Diseases Pub Date : 2024-12-01 Epub Date: 2024-10-23 DOI:10.1097/QCO.0000000000001070

Chiara Sepulcri, Claudia Bartalucci, Malgorzata Mikulska

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引用次数: 0

Abstract

Purpose of review: The purpose of this review is to report the available evidence regarding the use of combination regimens of antivirals and/or antibody-based therapy in the treatment of SARS-CoV-2 in immunocompromised patients.

Recent findings: Literature search identified 24 articles, excluding single case reports, which included mainly patients with hematological malignancies and/or B-cell depletion. Data were divided based on the timing and reason for administration of combination treatment, that is, early treatment to prevent progression to severe COVID-19 and treatment of prolonged or relapsed infection. We described the treated populations, treatment duration and composition of combination treatment. We briefly addressed new treatment options and we proposed an algorithm for the management of COVID-19 infection in patients affected by hematological malignancies.

Summary: Combination treatment seems an effective (73-100%) and well tolerated (<5% reported bradycardia, hepatotoxicity, neutropenia) strategy for treating prolonged/relapsed SARS-CoV-2 infections in the immunocompromised host, although its optimal composition and duration cannot be defined based on the currently available evidence. The role of combination treatment as an early treatment strategy for immunocompromised patients at a high risk of progression to severe disease/persistent shedding requires further evidence from comparison with monotherapy, even though high efficacy was reported for combinations of antivirals plus mAbs in case of previous viral variants.

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免疫力低下患者感染 SARS-CoV-2 的抗病毒综合治疗策略。

综述目的：本综述旨在报告免疫功能低下患者使用抗病毒药物和/或抗体疗法联合方案治疗 SARS-CoV-2 的现有证据：文献检索共发现 24 篇文章（不包括单个病例报告），其中主要包括血液恶性肿瘤和/或 B 细胞耗竭患者。数据根据联合治疗的时间和原因进行了划分，即早期治疗以防止病情恶化为重症COVID-19，以及治疗久治不愈或复发的感染。我们描述了接受治疗的人群、治疗持续时间和联合治疗的组成。我们简要介绍了新的治疗方案，并提出了治疗血液恶性肿瘤患者 COVID-19 感染的算法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Infectious Diseases 医学-传染病学

CiteScore

6.70

自引率

2.60%

发文量

121

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.