COVID-19. Opciones terapéuticas desde la viro-patogénesis a la evidencia clínica

Palabras clave: virus del SRAS, coronavirus, glicoproteína de la espiga del coronavirus, cloroquina, antivirales, inmunización pasiva, vacunas.

Resumen

Cada vez sabemos más sobre este enemigo mortal de la familia de los Betacoronavirus, llamado inicialmente 19-nCoV, causante de la COVID-19 (Coronavirus infectous disease por su sigla en inglés), hoy clasificado SARS-CoV-2, porque es responsable de producir el SARS (síndrome respiratorio agudo severo, por sus siglas en inglés) y que comparte una fuerte homología de secuencia con el SARS-CoV, su primo hermano causante de la epidemia en 2003 del SARS, ambos capaces de diseminarse rápidamente, en particular este, y causar un gran caos mundial como ha sucedido con esta pandemia. Con base en estudios previos de focalización en el SARS-CoV, y también en el virus causante del MERS (síndrome respiratorio del Oriente Medio, por sus siglas en inglés), y con el conocimiento que se tiene actualmente sobre el SARS-CoV-2, se exploran en este articulo algunas opciones terapéuticas para el manejo de la infección por este virus complejo y con capacidad letal, mencionando algunos aspectos de relevancia patogénica.
Se enfatizó en las posibles alternativas de manejo desde la fisiopatología y patogénesis hasta la evidencia actualmente disponible. Exploraremos el uso probable de ECA2 recombinante, algunas moléculas experimentales, revisaremos los antimaláricos (cloroquina e hidroxicloroquina), esteroides, azitromicina, antivirales específicos como remdesivir, lopinavir/ritonavir, biológicos como tocilizumab, anticuerpos monoclonales antivirales, y haremos énfasis en la trasfusión de plasma de convalecientes desde el principio de inmuni- zación pasiva, de gran utilidad.

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Publicado
2020-04-15
Cómo citar
1.
González J, González AM. COVID-19. Opciones terapéuticas desde la viro-patogénesis a la evidencia clínica. Rev. Colomb. Nefrol. [Internet]. 15 de abril de 2020 [citado 26 de noviembre de 2020];7(Supl.2). Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/433