Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is characterized by a wide spectrum of symptom severity, which is manifested at different phases of infection and demands different levels of care. Viral load, host innate-immune response to SARS-CoV-2, and comorbidities have a direct impact on the clinical outcomes of COVID-19 patients and determine the diverse disease trajectories. The initial SARS-CoV-2 penetrance and replication in the host causes death of infected cells, determining the viral response. SARS-CoV-2 replication in the host triggers the activation of host antiviral immune mechanisms, determining the inflammatory response. While a healthy immune response is essential to eliminate infected cells and prevent spread of the virus, a dysfunctional immune response can result in a cytokine storm and hyperinflammation, contributing to disease progression.
Current therapies for COVID-19 target the virus and/or the host immune system and may be complicated in their efficacy by comorbidities. Here we review the evidence for use of two classes of anti-inflammatory drugs, glucocorticoids and nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of COVID-19. We consider the clinical evidence regarding the timing and efficacy of their use, their potential limitations, current recommendations and the prospect of future studies by these and related therapies.
【저자키워드】 COVID-19, Inflammation, glucocorticoid, Immune-response, NSAID, Prostanoids, 【초록키워드】 Treatment, SARS-CoV-2, Coronavirus disease 2019, Efficacy, Cytokine storm, coronavirus, Anti-inflammatory drugs, immune response, therapy, Antiviral, Infection, Comorbidities, Comorbidity, virus, immune, Clinical outcome, Replication, NSAIDS, Spread, Disease progression, hyperinflammation, death, mechanisms, Care, SARS-CoV-2 replication, Therapies, Evidence, Inflammatory response, COVID-19 patient, Trigger, acute respiratory syndrome, Activation, nonsteroidal anti-inflammatory drug, infected cells, host immune system, symptom severity, clinical evidence, infected cell, potential limitations, while, Host, recommendation, Prevent, current, disease trajectories, initial, caused, healthy, characterized, determine, cause, contributing to, manifested, the timing, 【제목키워드】 nonsteroidal anti-inflammatory drug,