新冠肺炎住院病患處置之新進展

2019年末，一種新型冠狀病毒（SARS-CoV-2）在中國武漢被發現且迅速蔓延開來，並造成新冠肺炎（COVID-19 pneumonia）在2020年全世界大流行。台灣歷經了兩波疫情的高峰，隨著疫苗施打率的提升，新冠肺炎重症比例降低的情況下，台灣也迎來了疫情逐漸解封的曙光。在輕症但具重症之風險因子的病患族群可以公費使用奈瑪特韋（Nirmatrelvir與Ritonavir，商品名Paxlovid）和莫納皮拉韋（Molnupiravir，商品名Lagevrio）以及中藥清冠一號的狀況下，降低了病人進展成中重度需要住院治療的機率。除此之外，瑞德西韋（Remdesivir）可依據疾病的嚴重度分別給予三或五天的療程。嚴重肺炎之病人建議使用地塞米松類固醇（Dexamethasone），甚至合併瑞德西韋（Remdesivir）。Janus激酶抑制劑（Janus Kinase, JAK inhibitor, Baricitinib，商品名：愛滅炎）和介白素-6抑制劑（Interleukin-6 pathway inhibitors, Tocilizumab，商品名：安挺樂）也在臨床使用中證實使用在嚴重肺炎的病人身上具有好處，甚至在嚴重肺炎的病人身上也可以合併使用類固醇、瑞德西韋和Janus激酶抑制或介白素-6抑制劑。

關鍵字

嚴重急性呼吸道症候群－冠狀病毒2（Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2）； 2019冠狀病毒疾病（Coronavirus Disease, COVID-19）；嚴重特殊傳染性肺炎（COVID-19）；瑞德西韋（Remdesivir）

並列摘要

At the end of 2019, a novel coronavirus was identified in cluster of pneumonia patients and spreading rapidly in Wuhan, China, resulting in a global pandemic in 2020. Taiwan had experienced two times of outbreak and peak since 2020. The incidence and risk of critical illness of COVID-19 decreased gradually after most of the population has receivedthe administration of COVID-19 vaccine. Gradually easing of border restrictionsand unlocking the restriction for COVID-19 was announced. After years of development, Nirmatrelvir + Ritonavir (Paxlovid), Molnupiravir(Lagevrio) and NRICM101 are indicated for the patient who had the disease with mild severity and the risk factor of critical illness. These treatments reduced the risk of disease progression and hospitalization rates. For the hospitalized patients, remdesivir is also indicated as alternative treatment for mild disease. For the patient who required oxygen supply and severe disease, combination treatment by dexamethasone with the Remdesivir, JAK inhibitor (Baricitinib), or Interleukin-6 inhibitor (Tocilizumab) may improve survival and improve the recovery from the illness.

並列關鍵字

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