[Early post-exposure and curative therapeutic strategies against COVID-19].

Covid-19 : mise à jour des stratégies thérapeutiques curatives précoces et du patient sous oxygénothérapie.
Antibodies Anticorps Antiviral COVID-19 Nirmatrelvir Remdesivir Traitement Treatment

Journal

Revue des maladies respiratoires
ISSN: 1776-2588
Titre abrégé: Rev Mal Respir
Pays: France
ID NLM: 8408032

Informations de publication

Date de publication:
21 Nov 2023
Historique:
received: 22 04 2023
accepted: 25 10 2023
medline: 23 11 2023
pubmed: 23 11 2023
entrez: 22 11 2023
Statut: aheadofprint

Résumé

There now exist preventive and curative treatments available for both early and advanced stages of COVID-19 management. Antibiotics have no place in the initial therapeutic management of Sars-Cov-2 pneumonia. On the other hand, corticosteroids are recommended for patients requiring oxygen therapy≥2L/min. According to the latest recommendations, nirmatrelvir/ritonavir is indicated as an early treatment for adults not requiring oxygen therapy but at high risk of developing a severe form of COVID-19. In case of contraindication, remdesivir is an alternative therapy. Although there is no indication for convalescent plasma outside of clinical trials, it seems promising for immunocompromised patients, particularly those with B lymphopenia. It is noteworthy that currently, with the predominance of the Omicron XBB.1.5 variant, monoclonal antibodies are no longer recommended as therapy except for sotrovimab, which still has partial efficacy and could be considered after expert opinion as salvage therapy in a previously well-established program. Despite the evolution of variants, antivirals still appear to have activity and remain the first-line treatment for patients, in addition to vaccination.

Identifiants

pubmed: 37993363
pii: S0761-8425(23)00267-X
doi: 10.1016/j.rmr.2023.10.007
pii:
doi:

Types de publication

English Abstract Journal Article Review

Langues

fre

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Auteurs

K Jaffal (K)

Service de maladies infectieuses, hôpital universitaire Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.

B Davido (B)

Service de maladies infectieuses, hôpital universitaire Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; UMR 1173, université Paris Saclay, Versailles, France. Electronic address: benjamin.davido@aphp.fr.

Classifications MeSH