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NIH ÃֽŠ¾÷µ¥ÀÌÆ®µÈ COVID-19 Ä¡·áÁöħ ¿ä¾à 

- Last Updated: April 21, 2021-

(NIH COVID-19 Treatment Guidelines)

 

NIHÀÇ COVID-19 Ä¡·áÁöħ ÆгÎÀº ÇöÁö½Ã°£ 4¿ù 21ÀÏÀÚ·Î Äڷγª 19(COVID-19) ¾÷µ¥ÀÌÆ® µÈ »õ·Î¿î Ä¡·áÁöħÀ» ¹ßÇ¥Çß´Ù.

 

À̹ø¿¡ ¾÷µ¥ÀÌÆ® µÈ Ä¡·á Áöħ¿¡ ´ëÇÑ ÁÖ¿ä ³»¿ëÀ» ¿ä¾àÇÏ¸é ´ÙÀ½°ú °°´Ù.

 

1. ±Þ¼º COVID-19 ȯÀÚÀÇ ¿Ü·¡È¯ÀÚ °ü¸® ºÎºÐ(Outpatient Management of Acute COVID-19)

ÀÔ¿øÀÌ ÇÊ¿äÇÏÁö ¾ÊÀº °æÁõ¿¡¼­ Áߵ COVID-19 ȯÀÚÀÇ ¼±º°(screening), ºÐ·ù(triage) ¹× Ä¡·á °ü¸®(therapeutic management )¿¡ ´ëÇÑ ±ÇÀå»çÇ×À» Á¦°øÇÑ´Ù. ¶ÇÇÑ ÀÌ ¼½¼Ç¿¡¼­´Â COVID-19 ȯÀÚ°¡ ÀÀ±Þ½ÇÀ̳ª º´¿ø¿¡¼­ Åð¿ø ÈÄ °ü¸®ÇϱâÀ§ÇÑ ±ÇÀå »çÇ×À» Æ÷ÇÔÇÏ°í ÀÖ´Ù.

 

°æÁõ¿¡¼­ Áߵ COVID-19 ¿Ü·¡ ȯÀÚ¸¦ À§ÇÑ ±¸Ã¼Àû Ä¡·á

(Specific Therapy for Outpatients With Mild to Moderate COVID-19)



 

COVID-19 Ä¡·á Áöħ ÆгΠ(ÆгÎ)Àº ´ÙÀ½°ú °°Àº Ç× -SARS-CoV-2 ´ÜÀÏ Å¬·Ð Ç×ü Á¶ÇÕÀ» »ç¿ëÇÏ¿© ÀÓ»ó ÁøÇà À§ÇèÀÌ ³ôÀº °æÁõ¿¡¼­ Áߵ COVID-19 ȯÀÚ¸¦ Ä¡·áÇÒ °ÍÀ» ±ÇÀåÇÑ´Ù; ÀÀ±Þ »ç¿ë ½ÂÀÎ ±âÁØ (Ä¡·á´Â ¾ËÆĺª ¼ø¼­·Î ³ª¿­ µÊ) :

 

-Bamlanivimab 700mg + Etesevimab 1,400mg (AIIa);  ¶Ç´Â

-Casirivimab 1,200mg + Imdevimab 1,200mg (AIIa).





 

±×¸² 1) COVID-19ȯÀÚÀÇ ÁßÁßµµ¿¡ µû¸¥ ¾à¹°Ä¡·á °¡À̵å¶óÀÎ(Ãâó : NIH Therapeutic Management of Adults With COVID-19, Last Updated: April 21, 2021)




 

2. ÄÝÈ÷Ä£(Colchicine) »ç¿ë¿¡ ´ëÇÑ ºÎºÐ : À̹ø ¾÷µ¥ÀÌÆ®¿¡¼­ COVID-19 Ä¡·áÁöħ ÆгÎÀº COVID-19 È®ÁøÀÚ Áß¿¡¼­ ÀÔ¿øÇÏÁö ¾ÊÀº COVID-19 ȯÀÚ(nonhospitalized patients)¿¡°Ô ÄÝÈ÷Ä£(colchicine) Ä¡·á»ç¿ëÀ» ±ÇÀåÇϰųª ¹Ý´ëÇϱâÀ§ÇÑ µ¥ÀÌÅÍ°¡ ºÒÃæºÐÇÏ´Ù´Â »ç½ÇÀ» È®ÀÎÇß´Ù. 

 

¿Ü·¡ ȯÀÚ¸¦ ´ë»óÀ¸·Î ÇÑ ´ë±Ô¸ð ¹«ÀÛÀ§ ½ÃÇè ¿¬±¸, ÄÝÈ÷Ä£ Äڷγª ¹ÙÀÌ·¯½º SARS-CoV-2 ÀÓ»ó½ÃÇè(COLCORONA)¿¡¼­ 1Â÷ ¸ñÇ¥ÀÎ ÀÔ¿ø°ú »ç¸ÁÀ» °¨¼Ò½ÃÅ°´Â ¸ñÀû¿¡´Â µµ´ÞÇÏÁö ¸øÇß´Ù. ±×·¯³ª ÇÏÀ§±×·ìºÐ¼®¿¡¼­ COVOD-19 Áø´Ü°Ë»çÀÎ PCR Å×½ºÆ®, ºñÀεθéºÀ(nasopharyngeal swab on a SARS-CoV-2 polymerase chain reaction, PCR) °Ë»ç·Î COVID-19 Áø´ÜÀÌ È®ÀÎ µÈ ÀϺΠȯÀÚ¿¡¼­ ÀÔ¿øÀ² °¨¼Ò°¡ ÀϺΠ³ªÅ¸³µ´Ù. 

 

ÆгÎÀº COVID-19 ÀÔ¿ø ȯÀÚ¿¡°Ô ÄÝÈ÷Ä£(Colchicine) »ç¿ë ±ÝÁö¸¦ Á¦¾ÈÇß°í, ´Ü ÀÓ»ó½ÃÇè(clinical trial (AIII)) »ç¿ëÀº ¿¹¿ÜÇÔÀ» ¹àÇû´Ù. 



 

3. Ç÷纹»ç¹Î(Fluvoxamine) »ç¿ë¿¡ ´ëÇÑ ºÎºÐ : COVID-19 Ä¡·áÁöħ ÆгÎÀº Fluvoxamine »ç¿ë¿¡ ´ëÇÑ »õ·Î¿î ¾÷µ¥ÀÌÆ® Ä¡·áÁöħ°³¹ßÀ» À§ÇÏ¿©  ¼Ò±Ô¸ð ¹«ÀÛÀ§ ´ëÁ¶±º ½ÃÇ迬±¸ ¹× °üÂû ¿¬±¸ÀÇ °á°ú¸¦ °ËÅäÇß´Ù. 

 

¿¬±¸´ë»óÀÚ Æ¯¼º(Participant Characteristics)

-ÃÑ 152¸íÀÇ Âü°¡ÀÚ°¡ ¹«ÀÛÀ§·Î Ç÷纹»ç¹Î±º(n = 80) ¶Ç´Â À§¾à±º(n = 72)À¸·Î Åõ¿© ¹Þ¾Ò´Ù.

-Âü°¡ÀÚµéÀÇ Æò±Õ ¿¬·ÉÀº 46¼¼(72%-¿©¼º, 25%- ÈæÀÎ, 56%-ºñ¸¸)

 

¿¬±¸°á°ú(Results)

Ç÷纹»ç¹ÎÀ» Åõ¿©¹ÞÀº 80¸í Áß 0%¿Í À§¾à Åõ¿©±º 72¸í Áß 6 ¸í(8.3 %)ÀÌ 1 Â÷ Æò°¡ º¯¼ö¿¡ µµ´ÞÇß´Ù(absolute difference 8.7%; 95% CI, 1.8% to 16.5%; P = 0.009).  À§¾à±ºÀÇ ÇÑ Âü°¡ÀÚ´Â ÀÔ¿øÀÌ ÇÊ¿äÇß´Ù.

Âü°¡ÀÚÀÇ 76%¸¸ÀÌ ¿¬±¸¸¦ ¿Ï·áÇßÀ¸¸ç Âü°¡ÀÚÀÇ 20%´Â ¿¬±¸±â°£ µ¿¾È ¼³¹® Á¶»ç¿¡ ÀÀ´äÇÏÁö ¾Ê¾ÒÁö¸¸ ÃÖÁ¾ ºÐ¼®¿¡ Æ÷ÇԵǾú´Ù.

 

¿¬±¸Á¦ÇÑÁ¡(Limitations)

- Ç¥º» Å©±â°¡ ÀÛÀ½.

- ¸ñÇ¥´Þ¼ºÀÌ Á¦ÇÑÀûÀÓ.

-¸ðµç Æò°¡°¡ ¿ø°ÝÀ¸·Î ¼öÇàµÇ¾ú±â ¶§¹®¿¡ ÀÓ»ó ¾ÇÈ­¸¦ È®ÀÎÇÏ´Â °ÍÀÌ ¾î·Á¿ò

 

°á·ÐÀûÀ¸·Î ÆгÎÀº COVID-19 Ä¡·á¸¦ À§ÇÑ Ç÷纹»ç¹Î »ç¿ëÀ» ±ÇÀåÇϰųª »ç¿ë±ÝÁöÇÒ ¼ö ÀÖ´Â °ü·Ã µ¥ÀÌÅÍ°¡ ¾ÆÁ÷±îÁö ÃæºÐÇÏÁö ¾Ê´Ù°í ÆÇ´ÜÇß´Ù.



 

4. COVID-19 ¼ºÀÎȯÀÚÀÇ Ä¡·á °ü¸®[Ç× -SARS-CoV-2 ´ÜÀÏ Å¬·Ð Ç×ü(anti-SARS-CoV-2 monoclonal antibodies)¿Í Åä½Ç¸®ÁÖ¸¿( tocilizumab, µ¦»ç¸ÞŸ¼Õ º´¿ë)] ºÎºÐ : COVID-19¿¡ °¨¿°µÈ ƯÁ¤ ȯÀÚ¿¡¼­ Ç× -SARS-CoV-2 ´ÜÀÏ Å¬·Ð Ç×ü(anti-SARS-CoV-2 monoclonal antibodies)¿Í Åä½Ç¸®ÁÖ¸¿( tocilizumab, µ¦»ç¸ÞŸ¼Õ º´¿ë)ÀÇ º´¿ë ½Ã±â¿¡ ´ëÇÑ ±ÇÀå »çÇ×ÀÌ Æ÷ÇԵǾî ÀÖ´Ù.




 

5. SARS-CoV-2 º¯Á¾ ¿ì·Á(SARS-CoV-2 Variants of Concern) : SARS-CoV-2 º¯Á¾ ¿ì·Á¿¡ ´ëÇÑ Á¤º¸°¡ COVID-19 °³¿ä(Overview of COVID-19) ÇÏÀ§ ¼½¼Ç¿¡ »õ·Ó°Ô Ãß°¡µÇ¾î ÀÖ´Ù. NIH´Â ¹Ì±¹³» ¹ÙÀÌ·¯½º µ¹¿¬º¯ÀÌ ¹× º¯ÀÌ ½ÃÄö½º ±â¹ÝÀ» ÅëÇÏ¿© º¯ÀÌ ¹ÙÀÌ·¯½º °¨½Ã ¹× ½ÇÇè½Ç ¿¬±¸ ¹× Áö¿ªº° ´Ù¾çÇÑ ¿ªÇÐ Á¶»ç¸¦ ÅëÇØ Áö¼ÓÀûÀ¸·Î ¸ð´ÏÅ͸µÇÏ°í ÀÖ´Ù. ¹Ì±¹ Á¤ºÎ Äڷγª19 °ü·Ã±â°üÀº ¿¬ÇÕÇÏ¿© SARS-CoV-2 º¯ÀÌÀÇ ¼¼ °¡Áö Ŭ·¡½º·Î º¯ÀÌ ºÐ·ù ü°è¸¦ °³¹ßÇß´Ù.



 



 

6. SARS-CoV-2 °¨¿°ÀÇ ÀÓ»ó ½ºÆåÆ®·³ ºÎºÐ :  ÀÌÀü¿¡ COVID-19¿¡ °üÇÑ ±â·ÏµÇ¾î Àִ ȯÀÚÀÇ SARS-CoV-2 Àç°¨¿°º¸°í¿¡ ´ëÇØ ±â¼úÇÑ´Ù. ±Þ¼º COVID-19 °¨¿° ÀÌÈÄ Áö¼ÓÀûÀÎ Áõ»óÀ̳ª Àå±â ±â´É Àå¾Ö¸¦ °æÇèÇϴ ȯÀÚ¿¡ ´ëÇÑ ÀÚ·áµµ ¾÷µ¥ÀÌÆ®µÇ¾ú´Ù.

 

7. Anti-SARS-CoV-2 ¸ð³ëŬ·Î ³¯ Ç×ü(Anti-SARS-CoV-2 Monoclonal Antibodies) »ç¿ëºÎºÐ : »õ·Î¿î ¾÷µ¥ÀÌÆ®µÈ ºÎºÐ¿¡¼­´Â ÀÌÀü ºñ»ó»ç¿ë½ÂÀÎ(Emergency Use Authorizations)¿¡ °üÇÑ ÆгΠ¼º¸í¼­ Á¤º¸¿Í Anti-SARS-CoV-2 ¸ð³ëŬ·Î³¯Ç×ü¿¡ ´ëÇÑ  ±ÇÀå»çÇ×À» ÅëÇÕ½ÃÄ×´Ù. ÀÌ ºÎºÐ¿¡¼­´Â SARS-CoV-2 º¯ÀÌü¿Í µ¹¿¬º¯ÀÌ°¡ ´Ù¸¥ Ç× -SARS-CoV-2 ´ÜÀÏŬ·ÐÇ×ü(anti-SARS-CoV-2 monoclonal antibodies)¿¡ ´ëÇÑ ½ÃÇè°ü ³» °¨¼ö¼º¿¡ ¹ÌÄ¡´Â ÀáÀçÀû ¿µÇâ¿¡ ´ëÇÑ Á¤º¸µµ ÇÔ²² Æ÷ÇԵǾî ÀÖ´Ù.



 

8. ȸº¹±â Ç÷Àå(Convalescent Plasma) »ç¿ë ºÎºÐ : ÀÔ¿ø ÇÑ COVID-19 ȯÀÚ¿Í ÀÔ¿øÇÏÁö ¾ÊÀº COVID-19 ȯÀÚ¿¡¼­ ȸº¹±â Ç÷Àå Ä¡·á¿¡ ´ëÇÑ »õ·Î¿î ±ÇÀå »çÇ×ÀÌ Æ÷ÇԵǾî ÀÖ´Ù. »õ·Î¿î ÀÓ»ó µ¥ÀÌÅÍ Ç¥¿¡´Â COVID-19 ȯÀÚÀÇ È¸º¹±â Ç÷Àå »ç¿ë¿¡ ´ëÇÑ ¿©·¯ ¹«ÀÛÀ§ ÀÓ»ó ½ÃÇè ¹× ÈÄ ÇâÀû ÄÚȣƮ ¿¬±¸ °á°ú°¡ ¿ä¾àµÇ¾î ÀÖ´Ù.



 

9. Interleukin-6 Inhibitors »ç¿ëºÎºÐ : COVID-19·Î ÀÎÇØ ºü¸¥ È£Èí ºÎÀüÀ» º¸À̴ ƯÁ¤ ÀÔ¿ø ȯÀÚ¿¡¼­ tocilizumab°ú dexamethasoneÀ» »ç¿ëÇÏ´Â ¹æ¹ý¿¡ ´ëÇØ ¼³¸íÇÑ´Ù. ¾÷µ¥ÀÌÆ®µÈ »õ·Î¿î ÀÓ»ó µ¥ÀÌÅÍ Ç¥¿¡´Â COVID-19 ȯÀÚ¸¦ ´ë»óÀ¸·Î ÇÑ Åä½Ç¸®ÁÖ¸¿(tocilizumab) ¹× »ç¸±·ç¸¿(sarilumab) »ç¿ë¿¡ ´ëÇÑ ÁÖ¿ä ¿¬±¸ °á°ú°¡ ¿ä¾àµÇ¾î ÀÖ´Ù.



 

10. ±Þ¼º COVID-19 ¾Æµ¿ ȯÀÚ : ÆгÎÀº ±Þ¼º COVID-19 ¾Æµ¿ÀÇ Ä¡·á Áöħ°ú  °í·Á »çÇ׿¡ ´ëÇÑ ºÎºÐÀ»  Ãß°¡Çß´Ù. ÀÌ ¼¼¼Ç¿¡¼­´Â ¼Ò¾ÆÀÇ COVID-19, SARS-CoV-2 °¨¿°ÀÇ ¼öÁ÷ ÀüÆÄ ¹× ¼Ò¾ÆÀÇ ´ÙÁß ½Ã½ºÅÛ ¿°Áõ ÁõÈıº(Multisystem inflammatory syndrome in children, MIS-C)¿¡ ´ëÇÑ ¿ªÇÐ ¹× À§Çè ¿ä¼Ò¿¡ ´ëÇÑ ¾÷µ¥ÀÌÆ® µÈ Á¤º¸µµ Æ÷ÇԵǾî ÀÖ´Ù.



 

*Àüü ¾÷µ¥ÀÌÆ® ¸ñ·Ï ¹× COVID-19 Ä¡·á Áöħ À¥ »çÀÌÆ® Âü°í : https://www.covid19treatmentguidelines.nih.gov/?utm_campaign=+47103936&utm_content=&utm_medium=email&utm_source=govdelivery&utm_term=


 

 

 


2021-04-22 ¿ÀÈÄ 12:18:33, Á¶È¸¼ö : 1957