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2023, Número 1

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Mediciego 2023; 29 (1)


Valoración del uso del remdesivir para el tratamiento de la COVID-19

Arceo-Naranjo R, González-Blanco I, Díaz-Molina M

Idioma: Español
Referencias bibliográficas: 50
Paginas: 1-21
Archivo PDF: 766.19 Kb.


RESUMEN

Introducción: el remdesivir es un profármaco de amplio espectro antiviral que se utiliza para el tratamiento de pacientes hospitalizados por COVID-19.
Objetivo: valorar la evidencia científica disponible sobre el uso del remdesivir en el tratamiento de la COVID-19.
Métodos: se realizó una revisión de la bibliografía en las bases de datos disponibles en español e inglés de la Biblioteca Virtual de Salud, MEDLINE, Lilacs, SciELO, EBSCO y el buscador Google Académico desde 2018 hasta el 2021. Se seleccionaron 50 artículos con la información necesaria.
Desarrollo: las terapias con inhibidores de nucleótidos/nucleósidos dirigidos contra la polimerasa ADN y ARN, pudieran constituirse en los tratamientos medulares de la terapia antiviral. Cuando el remdesivir se convierte en un metabolito activo provoca la terminación de la cadena de ARN viral e inhibe la replicación viral, lo que ha sido confirmado en estudios pre-clínicos. La información disponible de los ensayos clínicos es controversial, sin embargo, se ha podido comprobar que mejora el tiempo de recuperación de los pacientes y la supervivencia. Aunque ha mostrado un perfil de seguridad favorable, aún se reportan reacciones adversas. El esquema de tratamiento de cinco días muestra buena eficacia y menor tasa de interrupción por efectos adversos; la vía inhalatoria parece mejorar la biodisponibilidad del remdesivir en los tejidos pulmonares.
Conclusiones: el remdesivir está recomendado para el tratamiento de enfermos hospitalizados con COVID-19 y requerimientos de oxígeno, sin embargo, se requieren más investigaciones en seres humanos para confirmar su eficacia clínica en estos pacientes.


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