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Dtsch Med Wochenschr 2022; 147(20): 1313-1320
DOI: 10.1055/a-1817-8872
DOI: 10.1055/a-1817-8872
Dossier
Medikamentöse Therapiemaßnahmen bei akuter SARS-CoV-2-Infektion: wer, wann und was?
Drug therapy interventions for acute SARS-CoV-2 infection: who, when, and what?
Mittlerweile gibt es eine Vielzahl von medikamentösen Therapieoptionen zur Behandlung einer akuten SARS-CoV-2-Infektion. Die aktualisierte S3-Leitlinie „Empfehlungen zur stationären Therapie von Patienten mit COVID-19“ gibt dazu klare Empfehlungen. Welche Therapie für welchen Patienten und in welcher Krankheitsphase am besten geeignet ist, muss individuell anhand der Risikofaktoren, der Komorbiditäten und der Kontraindikationen entschieden werden. Hierüber geben wir in diesem Beitrag einen Überblick.
Abstract
There is a variety of drug therapy options for treatment of acute SARS-CoV-2 infections. The updated S3 guideline “Recommendations for inpatient therapy of patients with COVID-19” provides clear recommendations in this regard. Which therapy is best suited for which patient and in which phase of the disease must be decided individually based on risk factors, comorbidities and contraindications. This article provides an overview.
Publication History
Article published online:
04 October 2022
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Literatur
- 1 Wichmann D, Matthews H, Nentwich MF. et al. Intensivmedizinisches Back-up bei infektiologischen Katastrophen. Med Klin Intensivmed Notfmed 2020; 115: 641-648 DOI: 10.1007/s00063-020-00743-7.
- 2 Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin e.V. SARS-CoV-2/COVID-19-Informationen & Praxishilfen für niedergelassene Hausärztinnen und Hausärzte. S2e-Leitlinie. AWMF-Register-Nr. 053-054; 04.02.2022. Im Internet (Stand: 12.09.2022): https://www.awmf.org/leitlinien/detail/ll/053-054.html
- 3 Kluge S, Janssens U, Welte T. et al S3-Leitlinie Empfehlungen zur stationären Therapie von Patienten mit COVID-19 – Living Guideline. AWMF-Register-Nr. 113-001LG; 12.09.2022. Im Internet (Stand: 14.09.2022): https://www.awmf.org/leitlinien/detail/ll/113-001LG.html
- 4 COVID-19-Therapieempfehlungen: Interaktive Orientierungshilfe für Ärztinnen und Ärzte. https://www.dgiin.de/covriin/index.html#/ ; Stand: 18.08.2022
- 5 Dennler U, Geisler F, Spinner CD. Declining COVID-19 morbidity and case fatality in Germany: the pandemic end?. Infection 2022; 1-2 DOI: 10.1007/s15010-022-01873-0.
- 6 Takashita E, Yamayoshi S, Simon V. et al. Efficacy of Antibodies and Antiviral Drugs against Omicron BA.2.12.1, BA.4, and BA.5 Subvariants. N Engl J Med 2022; 387: 468-470 DOI: 10.1056/NEJMc2207519.
- 7 Gottlieb RL, Vaca CE, Paredes R. et al. Early Remdesivir to Prevent Progression to Severe COVID-19 in Outpatients. N Engl J Med 2022; 386: 305-315 DOI: 10.1056/NEJMoa2116846.
- 8 Hammond J, Leister-Tebbe H, Gardner A. et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with COVID-19. N Engl J Med 2022; 386: 1397-1408 DOI: 10.1056/NEJMoa2118542.
- 9 Jayk Bernal A, Gomes da Silva MM, Musungaie DB. et al. Molnupiravir for Oral Treatment of COVID-19 in Nonhospitalized Patients. N Engl J Med 2022; 386: 509-520 DOI: 10.1056/NEJMoa2116044.
- 10 Horby P, Lim WS, Emberson JR. et al. Dexamethasone in Hospitalized Patients with COVID-19. N Engl J Med 2021; 384: 693-704 DOI: 10.1056/NEJMoa2021436.
- 11 Crothers K, DeFaccio R, Tate J. et al. Dexamethasone in hospitalised COVID-19 patients not on intensive respiratory support. Eur Respir J 2022; 60: 2102532 DOI: 10.1183/13993003.02532-2021.
- 12 Tan RSJ, Ng KT, Xin CE. et al. High-Dose versus Low-Dose Corticosteroids in COVID-19 Patients: a Systematic Review and Meta-analysis. J Cardiothorac Vasc Anesth 2022; 36: 3576-3586 DOI: 10.1053/j.jvca.2022.05.011.
- 13 Selvaraj V, Finn A, Lal A. et al. Baricitinib in hospitalised patients with COVID-19: A meta-analysis of randomised controlled trials. EClinicalMedicine 2022; 49: 101489 DOI: 10.1016/j.eclinm.2022.101489.
- 14 RECOVERY Collaboration Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet 2021; 397: 1637-1645 DOI: 10.1016/s0140-6736(21)00676-0.
- 15 Davidson M, Menon S, Chaimani A. et al. Interleukin-1 blocking agents for treating COVID-19. Cochrane Database Syst Rev 2022; 1: CD015308 DOI: 10.1002/14651858.Cd015308.
- 16 Deutsche Gesellschaft für Infektiologie (DGI). S1-Leitlinie SARS-CoV-2 Prä-Expositionsprophylaxe. AWMF-Register-Nr. 092-002; 09.05.2022. Im Internet (Stand: 18.08.2022): https://www.awmf.org/leitlinien/detail/ll/092-002.html
- 17 Wichmann D, Sperhake JP, Lütgehetmann M. et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19. Ann Intern Med 2020; 173: 268-277 DOI: 10.7326/m20-2003.
- 18 Ackermann M, Verleden SE, Kuehnel M. et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in COVID-19. N Engl J Med 2020; 383: 120-128 DOI: 10.1056/NEJMoa2015432.
- 19 Roubinian NH, Dusendang JR, Mark DG. et al. Incidence of 30-Day Venous Thromboembolism in Adults Tested for SARS-CoV-2 Infection in an Integrated Health Care System in Northern California. JAMA Intern Med 2021; 181: 997-1000 DOI: 10.1001/jamainternmed.2021.0488.
- 20 Piazza G, Campia U, Hurwitz S. et al. Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19. J Am Coll Cardiol 2020; 76: 2060-2072 DOI: 10.1016/j.jacc.2020.08.070.
- 21 Connors JM, Brooks MM, Sciurba FC. et al. Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial. JAMA 2021; 326: 1703-1712 DOI: 10.1001/jama.2021.17272.
- 22 Ananworanich J, Mogg R, Dunne MW. et al. Randomized study of rivaroxaban vs. placebo on disease progression and symptoms resolution in high-risk adults with mild COVID-19. Clin Infect Dis 2021; ciab813 DOI: 10.1093/cid/ciab813.
- 23 Lawler PR, Goligher EC, Berger JS. et al. Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with COVID-19. N Engl J Med 2021; 385: 790-802 DOI: 10.1056/NEJMoa2105911.
- 24 Goligher EC, Bradbury CA, McVerry BJ. et al. Therapeutic Anticoagulation with Heparin in Critically Ill Patients with COVID-19. N Engl J Med 2021; 385: 777-789 DOI: 10.1056/NEJMoa2103417.