前事不忘，后事之师--抗病毒药物利巴韦林联合干扰素治疗冠状病毒引发中东呼吸道综合症MERS的失败经验

anrey573

引发武汉肺炎的新冠状病毒毒株2019-nCoV是首次发现，没有现成的指南可以借鉴，可以借鉴的是2012年爆发的中东呼吸道综合症MERS冠状病毒的治疗经验。
Since the first report of infection with the Middle East Respiratory Syndrome coronavirus (MERS-CoV) was published in 2012, the World Health Organization has been notified of 2123 laboratory-confirmed infections with MERS-CoV from 27 countries and at least 740 reported deaths (case fatality 35%) [1]. There is no specific therapy of proven efficacy available and no potential treatment has been tested in a randomized clinical trial (RCT) for evaluation [2–4]. Based on results from in vitro and animal studies of MERS-CoV infection, the guanosine analog ribavirin, in combination with interferon alpha (IFN-α), has been used to treat patients with MERS [5–8]. However, the concentration of ribavirin required to inhibit MERS-CoV in vitro exceeds peak levels in the blood after therapeutic doses in humans [9–11]. Furthermore, retrospective studies with IFN-α2a, IFN-α2b or IFN-β1a in combination with ribavirin have not shown a clear benefit in patients with MERS [6–8, 12]
这段话说的是标准剂量的抗病毒药物利巴韦林ribavirin在血液中的浓度无法抑制MERS冠状病毒， 这就是为什么体外实验和动物实验有效的利巴韦林在临床上无效的原因。


对于同济/协和/武汉病毒所/武汉大学来说，如果要使用利巴韦林ribavirin治疗武汉肺炎，就需要证明这药在血液中的浓度可以抑制新冠状病毒毒株2019-nCoV。


这事我不知道同济和协和医院行不行，不行就需要让武汉病毒所和武大来处理了。如果武汉没人能做到这一点，就需要向其他机构求助了。