The end of the year 2019 marked the beginning of a health, economic and social crisis due to the global spread of a virus commonly called COVID-19. On Jan. 9, 2020, the World Health Organization (WHO) declared that Chinese health authorities had detected a new strain of coronavirus never before identified in humans, tentatively named 2019-nCoV and later officially classified as SARS-CoV-2. The virus is associated with an outbreak of pneumonia cases recorded since Dec. 31, 2019, in the central Chinese city of Wuhan. On Feb. 11, WHO announced that the respiratory disease caused by the new coronavirus has been named COVID-19. On January 30, the Istituto Superiore di Sanità (ISS) confirmed the first two cases of COVID-19 infection in Italy, and on February 21, it confirmed the first autochthonous case in Italy. (ISS, 2020) This disease, which is unknown to all and has taken mostly physicians, infectious disease specialists, researchers and virologists by surprise, has given the trigger to a deep and urgent search for drug therapies, suitable to treat the different and very often severe symptoms, developed by those affected by the virus. In this thesis, the SARS-CoV-2 virus will be introduced and presented in all its aspects, from its origin, to its morphological structure, to its mechanism of action, thanks to the collection of information found in scientific literatures. This is followed by a study of the various modes of transmission of the virus and a mention of the different techniques for diagnosing COVID-19 infection (molecular tests or serological tests). Finally, the symptomatology in the different clinical cases will be treated, in which the multiple clinical manifestations as well as mild to moderate and severe symptoms will be described and discussed in depth, including through the analysis of statistical studies of the different cases. Through this introduction, it has been possible to understand the need to prepare treatment plans aimed at coping with SARS-CoV-2. For these reasons, the objective of this thesis is to analyze the type of drugs that have been made available, from the beginning of the pandemic to the present, considering the choices made by the Italian Drug Agency (AIFA), which has been entrusted with the task of evaluating all clinical trials on drugs for patients with COVID-19 (Decree Law Cure Italy Art.17). This elaboration aims to integrate all the information gathered from the different scientific information sources available, in order to provide a general picture of the use of COVID-19 medicines at the national level and to highlight the prevention and treatment activities that our country is facing in this pandemic period.
La fine dell’anno 2019 ha segnato l’inizio di una crisi sanitaria, economica e sociale dovuta alla diffusione a livello globale di un virus comunemente chiamato COVID-19. Il 9 gennaio 2020 l'Organizzazione Mondiale della Sanità (OMS) ha dichiarato che le autorità sanitarie cinesi hanno individuato un nuovo ceppo di coronavirus mai identificato prima nell'uomo, provvisoriamente chiamato 2019-nCoV e classificato in seguito ufficialmente con il nome di SARS-CoV-2. Il virus è associato a un focolaio di casi di polmonite registrati a partire dal 31 dicembre 2019 nella città di Wuhan, nella Cina centrale. L'11 febbraio, l'OMS ha annunciato che la malattia respiratoria causata dal nuovo coronavirus è stata chiamata COVID-19. Il 30 gennaio, l'Istituto Superiore di Sanità (ISS) ha confermato i primi due casi di infezione da COVID-19 in Italia e il 21 febbraio ha confermato il primo caso autoctono in Italia. (ISS, 2020) Questa patologia, sconosciuta a tutti e che ha preso alla sprovvista soprattutto medici, infettivologi, ricercatori e virologi, ha dato l’innesco ad una profonda ed urgente ricerca di terapie farmacologiche, adatte a curare i diversi e molto spesso gravi sintomi, sviluppati dai soggetti affetti dal virus. In questa tesi verrà introdotto e presentato il virus SARS-CoV-2 in tutti i suoi aspetti, dall’origine, alla struttura morfologica, al suo meccanismo d’azione, grazie alla raccolta di informazioni presenti nelle letterature scientifiche. Segue poi uno studio sulle varie modalità di trasmissione del virus e una menzione sulle diverse tecniche per diagnosticare l’infezione da COVID-19 (test molecolari o test sierologici). Verrà infine trattata la sintomatologia nei diversi casi clinici, nella quale saranno descritte e approfondite le molteplici manifestazioni cliniche, nonché i sintomi da lievi a moderati e i sintomi gravi, anche attraverso l’analisi di studi statistici dei diversi casi. Grazie a questa introduzione è stato possibile comprendere l’esigenza di predisporre di piani terapeutici volti a fronteggiare il virus SARS-CoV-2. Per tali ragioni, l’obiettivo di questa tesi è quello di analizzare la tipologia di farmaci che sono stati messi a disposizione, dall’inizio della pandemia ad oggi, considerando le scelte assunte dall’Agenzia Italiana del Farmaco (AIFA), a cui è stato affidato il compito di valutare tutte le sperimentazioni cliniche sui medicinali per pazienti con COVID-19 (Decreto Legge Cura Italia Art.17). Tale elaborato mira a integrare tutte le informazioni raccolte dalle diverse fonti scientifiche informative disponibili, al fine di fornire un quadro generale sull’utilizzo dei medicinali per il COVID-19 a livello nazionale e di evidenziare le attività di prevenzione e cura che il nostro Paese sta affrontando in questo periodo di pandemia.
COVID-19: il punto sulle terapie in uso e nuovi approcci farmacologici per il trattamento dell?infezione da SARS-CoV-2
GREGORIO, GIULIA
2020/2021
Abstract
The end of the year 2019 marked the beginning of a health, economic and social crisis due to the global spread of a virus commonly called COVID-19. On Jan. 9, 2020, the World Health Organization (WHO) declared that Chinese health authorities had detected a new strain of coronavirus never before identified in humans, tentatively named 2019-nCoV and later officially classified as SARS-CoV-2. The virus is associated with an outbreak of pneumonia cases recorded since Dec. 31, 2019, in the central Chinese city of Wuhan. On Feb. 11, WHO announced that the respiratory disease caused by the new coronavirus has been named COVID-19. On January 30, the Istituto Superiore di Sanità (ISS) confirmed the first two cases of COVID-19 infection in Italy, and on February 21, it confirmed the first autochthonous case in Italy. (ISS, 2020) This disease, which is unknown to all and has taken mostly physicians, infectious disease specialists, researchers and virologists by surprise, has given the trigger to a deep and urgent search for drug therapies, suitable to treat the different and very often severe symptoms, developed by those affected by the virus. In this thesis, the SARS-CoV-2 virus will be introduced and presented in all its aspects, from its origin, to its morphological structure, to its mechanism of action, thanks to the collection of information found in scientific literatures. This is followed by a study of the various modes of transmission of the virus and a mention of the different techniques for diagnosing COVID-19 infection (molecular tests or serological tests). Finally, the symptomatology in the different clinical cases will be treated, in which the multiple clinical manifestations as well as mild to moderate and severe symptoms will be described and discussed in depth, including through the analysis of statistical studies of the different cases. Through this introduction, it has been possible to understand the need to prepare treatment plans aimed at coping with SARS-CoV-2. For these reasons, the objective of this thesis is to analyze the type of drugs that have been made available, from the beginning of the pandemic to the present, considering the choices made by the Italian Drug Agency (AIFA), which has been entrusted with the task of evaluating all clinical trials on drugs for patients with COVID-19 (Decree Law Cure Italy Art.17). This elaboration aims to integrate all the information gathered from the different scientific information sources available, in order to provide a general picture of the use of COVID-19 medicines at the national level and to highlight the prevention and treatment activities that our country is facing in this pandemic period.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/14504