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2020, vol. 49, br. 3, str. 43-54
Dosadašnja saznanja o etiopatogenezi i mogućnostima terapije Kovid-19
aUniverzitet u Nišu, Medicinski fakultet
bn/a

e-adresasrdjan.pesic@gmail.com
Ključne reči: Kovid-19; etiopatogeneza; terapija
Sažetak
Trenutno je u svetu od Kovida-19 obolelo preko 35 miliona ljudi, a preko milion je umrlo. Pandemijski karakter bolesti je nametnuo dinamična istraživanja, kako u oblasti razjašnjavanja etiopatogenetskih mehanizama bolesti, tako i u oblasti moguće terapije. Količina naučnih znanja se u poslednjih devet meseci nekoliko desetina puta uvećala, ali i dalje nismo ni blizu definisanju efikasne i sigurne terapije. Saznanje da je Kovid-19 ne samo respiratorno, već i multisistemsko oboljenje, koje zahvata skoro sve organe, dalo NAM je mogućnosti za terapijska prilagođavanja. Jak oksidacioni stres, tiha hronična hipoksija, povećana koagulabilnost i povećana agregacija trombocita, samo su neki od mehanizama u razvoju bolesti. Smatra se da su kardiovaskularne posledice i poremećaj funkcije endotela krvnih sudova uglavnom odgovorni za smrtni ishod, uz opasnu citokinsku oluju i akutni respiratorni distres sindrom. Imajući sve ovo u vidu, u terapijskom smislu, kod već obolelih osoba, predložena je primena antibiotika, visokih doza vitamina C zbog antioksidacionog dejstva, transfuzije krvi, imunoglobulina, interferona, anti-IL-6 antitela, malih doza deksametazona ili drugih kortikosteroida, specifičnih antivirusnih lekova, favipiravira i remdesivira. Primena hlorokina isključena je iz terapijskih protokola Svetske zdravstvene organizacije i američkih Centara za kontrolu i prevenciju bolesti. U preventivne i suportivne svrhe savetuju se visoke doze vitamina D, vitamina C, cinka, probiotika, alfalipoinske kiseline i drugih suplemenata. Primena antinflamatornih analgo-antipiretika smatra se opravdanom, kao i primena malih doza acetilsalicilne kiseline. Preko 70 drugih lekova se trenutno ispituje u preko 400 kliničkih studija. Kod pacijenata koji već inhalatorno ili intranazalno koriste kortikosteroide zbog astme, hronične opstruktivne bolesti pluća, alergijskog rinitisa, ili biološke lekove zbog imunomodulisanih inflamatornih bolesti, ovu terapiju ne treba menjati i ona nije preduslov za teže oblike bolesti. Moraju se uzeti u obzir i specifičnosti infekcije kod posebnih populacija kakve su deca ili trudnice.
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O članku

jezik rada: srpski, engleski
vrsta rada: pregledni članak
DOI: 10.5937/zdravzast49-28409
primljen: 15.09.2020.
revidiran: 08.10.2020.
prihvaćen: 09.10.2020.
objavljen onlajn: 09.10.2020.
objavljen u SCIndeksu: 24.10.2020.

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