DIRECTIONS OF ETIOTROPIC THERAPY IN THE TREATMENT OF COVID-19 IN COMORBID PATIENTS: CURRENT STRATEGIES AND PROSPECTS

In the context of the global COVID-19 pandemic, special attention was paid to the treatment of patients with comorbid conditions who are at increased risk of developing severe forms of the disease and death. This article provides an overview of modern approaches to etiotropic therapy of COVID-19, focusing on the use of antiviral drugs and janus kinase inhibitors and monoclonal antibodies in the treatment of comorbid patients. The research results demonstrate the importance of timely initiation of therapy to improve the outcomes of the disease and prevent the development of complications. Objective: to review and analyze current strategies for etiotropic therapy of COVID-19 in patients with comorbid conditions. Materials and methods: Within the framework of this study, the assessment and analysis of current strategies for etiotropic therapy of COVID-19 in patients with comorbid conditions was carried out. PubMed, Cochrane Library, Google Scholar databases were used, ClinicalTrials.gov, CDC, UpToDate, Medscape, NCBI and WHO. Articles containing data on clinical trials and reviews focusing on the etiotropic therapy of COVID-19 in comorbid conditions were included. Results: Data analysis showed that the most effective antiviral drugs for the treatment of COVID-19 in comorbid patients are nirmarelvir/ritonavir, remdesivir and molnupiravir. These drugs have demonstrated a significant reduction in the risk of hospitalization and mortality with timely initiation of therapy. It has also been shown that drugs such as dexamethasone and tocilizumab play an important role in the treatment of severe forms of COVID-19 in patients with multiple chronic diseases. Conclusions: Patients with comorbid conditions require special attention and early initiation of etiotropic therapy to prevent severe forms of COVID-19 and complications. Nirmarelvir/ritonavir, remdesivir and molnupiravir are the most promising drugs for the treatment of this category of patients, demonstrating high efficacy and safety in clinical trials.