6 Magungunan COVID-19 masu Taimakawa Marasa lafiya Su tsira
6 Magungunan COVID-19 masu Taimakawa Marasa lafiya Su tsira
Anonim

Shekara guda da ta gabata, lokacin da hukumomin kiwon lafiya na Amurka suka ba da gargaɗin farko cewa COVID-19 na iya haifar da “damuwa ga rayuwar yau da kullun,” likitoci ba su da ingantattun jiyya da za su iya bayarwa fiye da kulawar tallafi.

Har yanzu babu magani cikin sauri, amma godiya ga ƙoƙarin bincike na duniya wanda ba a taɓa ganin irinsa ba, jiyya da yawa suna taimaka wa marasa lafiya su tsira daga COVID-19 kuma su daina zuwa asibiti gaba ɗaya.

Magungunan COVID-19 suna fuskantar manyan matsaloli guda biyu: ikon coronavirus yaduwa ta cikin jiki, da lalacewar da tsarin garkuwar jiki ya haifar. Lokacin da kwayar cutar ta shiga cikin jiki, takan dauki kwayoyin halitta kuma ta yi amfani da su don yin kanta. A cikin martani, jiki yana aika siginar kumburi da ƙwayoyin rigakafi don yaƙar cutar. A wasu marasa lafiya, wannan amsa mai kumburi na iya ci gaba ko da bayan an sarrafa kwayar cutar, wanda ke haifar da lalacewa a cikin huhu da sauran gabobin.

Mafi kyawun kayan aiki shine rigakafi, gami da amfani da abin rufe fuska da alluran rigakafi. Alurar rigakafi suna horar da tsarin rigakafi don yakar maharan. Tare da ƙarancin kamuwa da kamuwa da cuta wanda ba a sarrafa shi ba, za su iya yanke haɗarin mutuwa daga COVID-19 zuwa kusa da sifili. Amma kayayyakin rigakafin suna da iyaka, har ma da allurar rigakafi ta uku da aka ba da izini don amfani da Amurka, don haka jiyya ga masu kamuwa da cutar suna da mahimmanci.

A matsayinmu na likitocin da ke aiki tare da marasa lafiya na COVID-19, muna bin gwajin magunguna da labarun nasara. Anan akwai jiyya guda shida da aka saba amfani da su a yau don COVID-19. Kamar yadda kake gani, lokaci yana da mahimmanci.

Magungunan da zasu iya hana ku zuwa asibiti

Nau'o'in jiyya guda biyu masu ban sha'awa sun haɗa da allurar rigakafin rigakafi a cikin majinyatan COVID-19 masu haɗari kafin mutum ya kamu da rashin lafiya.

Jikinmu a zahiri yana ƙirƙirar ƙwayoyin rigakafi don gane mahara na ƙasashen waje da kuma taimakawa wajen yaƙar su. Amma samar da maganin rigakafi na halitta yana ɗaukar kwanaki da yawa, kuma SARS-CoV-2 - coronavirus wanda ke haifar da COVID-19 - yana kwafi da sauri. Nazarin ya nuna cewa allurar rigakafi da sauri bayan bayyanar cututtuka na iya taimakawa wajen kare marasa lafiya daga kamuwa da cuta mai tsanani.

Monoclonal antibodies: Waɗannan ƙwayoyin rigakafin da aka yi amfani da su na iya haɗawa da SARS-CoV-2 kuma suna hana ƙwayar cuta shiga sel da kamuwa da su. Sun haɗa da Bamlanivimab da haɗin gwiwar casirivimab / imdevimab wanda Regeneron ya haɓaka. Hukumar Abinci da Magunguna ta Amurka ta ba da izinin yin amfani da gaggawa don waɗannan hanyoyin kwantar da hankali saboda an gano su don kare majinyata masu haɗari daga asibiti da mutuwa. Da zarar marasa lafiya ba su da lafiya don buƙatar asibiti, duk da haka, binciken bai sami tabbataccen fa'ida daga gare su ba.

Ƙwararren plasma: Wata hanyar isar da ƙwayoyin rigakafi ta ƙunshi jinin da aka zana daga marasa lafiya waɗanda suka murmure daga COVID-19. Ana ba da ƙwayar plasma da farko a cikin saitunan bincike saboda shaidar asibiti ya zuwa yanzu an gauraye. Wasu gwaje-gwajen suna nuna fa'idodi a farkon cutar. Sauran nazarin ba su nuna wani fa'ida ba a cikin marasa lafiya na asibiti.

Ana iya samun rawar don plasma convalescent azaman ƙarin jiyya ga wasu marasa lafiya saboda haɓakar barazanar bambance-bambancen SARS-CoV-2, wanda na iya guje wa maganin rigakafin ƙwayar cuta na monoclonal. Duk da haka, bincike mai zurfi ya zama dole.

Magani ga marasa lafiya a asibiti

Da zarar marasa lafiya sun yi rashin lafiya har sai an kwantar da su a asibiti, jiyya na canzawa.

Yawancin marasa lafiya na asibiti suna da wahalar numfashi da ƙarancin iskar oxygen. Ƙananan iskar oxygen yana faruwa a lokacin da kwayar cutar da amsawar rigakafi ta dace ta cutar da huhu, wanda ke haifar da kumburi a cikin jakar iska ta huhu wanda ke hana adadin iskar oxygen shiga cikin jini. Marasa lafiya da ke asibiti tare da COVID-19 yawanci suna buƙatar ƙarin iskar oxygen don taimaka musu numfashi. Likitoci akai-akai suna kula da marasa lafiya akan iskar oxygen tare da wakilin antiviral remdesivir da corticosteroids masu kumburi.

Remdesivir: Remdesivir, wanda aka yi shi da farko don magance cutar hanta ta C, ya hana coronavirus yin kwafin kansa ta hanyar yin kutse da tubalan ginin halittarsa. An nuna cewa yana rage tsawon zaman asibiti, kuma likitoci na iya rubuta wa marasa lafiya da iskar oxygen jim kadan bayan isa asibiti.

Corticosteroids: Steroids yana kwantar da martani na rigakafi na jiki kuma an yi amfani dashi shekaru da yawa don magance cututtuka masu kumburi. Hakanan ana samun su ko'ina, magunguna masu arha kuma ƙwararru, don haka suna cikin magungunan farko don shiga gwajin asibiti don COVID-19. Yawancin karatu sun nuna cewa ƙananan ƙwayoyin steroid sun rage mutuwar marasa lafiya a asibiti waɗanda ke kan iskar oxygen, ciki har da marasa lafiya marasa lafiya a cikin sashin kulawa mai zurfi, ko ICU. Biyo bayan binciken alamar RECOVERY da binciken REMAP-CAP COVID-19, steroids yanzu sune ma'aunin kulawa ga marasa lafiya da ke kwance a asibiti tare da COVID-19 waɗanda ake yi musu magani da iskar oxygen.

Magungunan jini: Kumburi yayin COVID-19 da sauran cututtukan ƙwayoyin cuta kuma na iya ƙara haɗarin gudanwar jini, wanda zai iya haifar da bugun zuciya, shanyewar jiki da gudan jini mai haɗari a cikin huhu. Yawancin marasa lafiya da ke da COVID-19 ana ba su magungunan heparin ko enoxaparin don hana gudan jini kafin su faru. Bayanai na farko daga babban gwaji na marasa lafiya na COVID-19 sun nuna cewa majinyatan da ke asibiti suna amfana daga mafi girman allurai na masu rage jini.

Wasu marasa lafiya da ke da COVID-19 sun yi rashin lafiya har suna buƙatar ICU don manyan matakan tallafin oxygen ko na'urar iska don taimaka musu numfashi. Akwai magunguna da yawa da ake samu ga majinyatan ICU, amma ba a sami majinyatan ICU da za su amfana da yawan adadin masu ba da jini ba.

Magance marasa lafiya

Marasa lafiya na ICU da ke da COVID-19 sun fi iya rayuwa idan sun karɓi steroid, binciken ya gano. Duk da haka, ƙananan ƙwayoyin steroid kawai bazai isa ya hana kumburi mai yawa ba.

Tocilizumab: Tocilizumab wani maganin rigakafi ne wanda aka samar da lab wanda ke toshe hanyar interleukin-6, wanda zai iya haifar da kumburi yayin COVID-19 da sauran cututtuka. Sabbin sakamako daga gwaji na REMAP-CAP wanda har yanzu ba a sake duba takwarorinsu ba ya nuna cewa kashi ɗaya na tocilizumab da aka ba a cikin kwana ɗaya zuwa kwana biyu bayan an sanya shi a kan tallafin numfashi ya rage haɗarin mutuwa a cikin marasa lafiya da ke karɓar ƙananan ƙwayoyin cuta. An kuma nuna Tocilizumab don amfanar marasa lafiya tare da ƙananan kumburi a sakamakon farko daga wani gwaji.

Waɗannan sabbin hanyoyin kwantar da hankali na iya taimakawa, amma kulawar kulawa a hankali a cikin ICU shima yana da mahimmanci. Shekaru da yawa na bincike mai zurfi sun ayyana ainihin ƙa'idodin gudanarwa don taimaka wa marasa lafiya da ke fama da cututtukan huhu masu tsananin gaske waɗanda ke buƙatar injin iska. Wadannan sun hada da guje wa rashin hauhawar farashin kayayyaki da hauhawar farashin huhu ta hanyar na'ura mai ba da hanya tsakanin hanyoyin sadarwa, magance zafi da damuwa tare da ƙananan magungunan kwantar da hankali, da kuma sanya wasu marasa lafiya lokaci-lokaci tare da ƙarancin iskar oxygen a cikin su, a cikin wasu ayyuka masu yawa. Maɓalli iri ɗaya masu yuwuwa sun shafi marasa lafiya tare da COVID-19 don taimaka musu su tsira da murmurewa daga mummunar rashin lafiya da za ta iya ɗaukar makonni ko watanni.

Ci gaban likita tun farkon barkewar cutar ya kasance abin ban tsoro. Likitoci yanzu suna da alluran rigakafi, ƙwayoyin rigakafin ƙwayoyin cuta don masu fama da haɗari masu haɗari da kuma jiyya da yawa ga marasa lafiya a asibiti. Ci gaba da bincike zai kasance mai mahimmanci don inganta iyawarmu don yaƙar cutar da ta rigaya ta lakume rayuka sama da miliyan 2.5 a duniya.

William G. Bain, Mataimakin Farfesa na Medicine, Jami'ar Pittsburgh; Georgios D. Kitsios, Mataimakin Farfesa na Medicine, Jami'ar Pittsburgh, da Tomeka L. Suber, Mataimakin Farfesa na Medicine, Jami'ar Pittsburgh

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