Современные подходы к лечению острых респираторных вирусных инфекций и гриппа - Журнал Терапевтический архив №11 Инфекционные болезни 2025

Современные подходы к лечению острых респираторных вирусных инфекций и гриппа

Трушина О.Ю. Современные подходы к лечению острых респираторных вирусных инфекций и гриппа. Терапевтический архив. 2025;97(11):950–954. DOI: 10.26442/00403660.2025.11.203505

© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.

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Trushina OIu. Contemporary approaches to the treatment of acute respiratory viral infections and influenza. A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2025;97(11):950–954. DOI: 10.26442/00403660.2025.11.203505

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Аннотация

Статья посвящена обзору современных подходов к лечению острых респираторных вирусных инфекций и гриппа у взрослых, в том числе из групп риска. Обсуждаются как основные механизмы действия препаратов, так и доказательная база применения в различных клинических ситуациях, включая профилактику осложнений. Обозначены основные перспективы развития этого направления с учетом особенностей возбудителей.

Ключевые слова: острая респираторная инфекция, грипп, вирусная инфекция, этиотропное лечение, прогноз, комбинированная терапия гриппа, комбинированная терапия ОРВИ

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The article’s scope is to review the modern approaches to the treatment of acute respiratory viral infections and influenza in adults, including those go higher risk. Both the main mechanisms of action of the drugs and the evidence base of their use in various clinical situations, including the prevention of complications, are discussed. The main prospects for the development of this area are outlined, taking into account the characteristics of pathogens.

Keywords: acute respiratory infection, influenza, viral infection, etiotropic treatment, prognosis, combination therapy of influenza, combination therapy of acute respiratory viral infections

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Список литературы

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16. Okoli GN, Otete HE, Beck CR, et al. Use of neuraminidase inhibitors for rapid containment of influenza: a systematic review and meta-analysis of individual and household transmission studies. PLoS One. 2014;9(12):e113633. DOI:10.1371/journal.pone.0113633
17. Miyashita N. Contemporary Concise Review 2024: Respiratory Infections. Respirology. 2025;30(10):926-34. DOI:10.1111/resp.70113
18. Dobson J, Whitley RJ, Pocock S, et al. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet. 2015;385(9979):1729-37. DOI:10.1016/S0140-6736(14)62449-1
19. Malosh RE, Martin ET, Heikkinen T, et al. Efficacy and Safety of Oseltamivir in Children: Systematic Review and Individual Patient Data Meta-analysis of Randomized Controlled Trials. Clin Infect Dis. 2018;66(10):1492-500. DOI:10.1093/cid/cix1040
20. Hanage WP, Schaffner W. Burden of Acute Respiratory Infections Caused by Influenza Virus, Respiratory Syncytial Virus, and SARS-CoV-2 with Consideration of Older Adults: A Narrative Review. Infect Dis Ther. 2025;14(Suppl. 1):5-37. DOI:10.1007/s40121-024-01080-4
21. Branda F, Petrosillo N, Yon DK, et al. Comprehensive Analysis of Influenza Viruses’ Trends in Italy: Insights from a Nationwide and Regional Perspective. Infect Dis Rep. 2025;17(2):20. DOI:10.3390/idr17020020
22. Kumar D, Ison MG, Mira JP, et al. Combining baloxavir marboxil with standard-of-care neuraminidase inhibitor in patients hospitalised with severe influenza (FLAGSTONE): a randomised, parallel-group, double-blind, placebo-controlled, superiority trial. Lancet Infect Dis. 2022;22(5):718-30. DOI:10.1016/S1473-3099(21)00469-2
23. Hui DS, Lee N, Chan PK, Beigel JH. The role of adjuvant immunomodulatory agents for treatment of severe influenza. Antiviral Res. 2018;150:202-16. DOI:10.1016/j.antiviral.2018.01.002
24. Hui DSC, Chan KKP. Host Immunomodulatory Interventions in Severe Influenza. J Infect Dis. 2025;232(Suppl. 3):S262-72. DOI:10.1093/infdis/jiaf328
25. Васин А.А., Миронова О.Ю., Фомин В.В. Влияние аторвастатина на профилактику контраст-индуцированного острого повреждения почек при проведении компьютерной томографии с внутривенным контрастированием. Терапевтический архив. 2022;94(9):1057-61 [Vasin AA, Mironova OIu, Fomin VV. The atorvastatin effects on the prevention of contrast-induced acute kidney injury during computed tomography with contrast media. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1057-61 (in Russian)]. DOI:10.26442/00403660.2022.09.201845
26. Васин А.А., Миронова О.Ю., Фомин В.В. Профилактика контраст-индуцированного острого повреждения почек при внутривенном введении контрастного препарата нагрузочными дозами статинов. Евразийский Кардиологический Журнал. 2022;(3):84-8 [Vasin AA, Mironova OIu, Fomin VV. Intravenous contrast induced acute kidney injury prevention with high doses of statins. Eur Card Rev. 2022;(3):84-8 (in Russian)]. DOI:10.38109/2225-1685-2022-3-84-88
27. Weitz-Schmidt G, Welzenbach K, Brinkmann V, et al. Statins selectively inhibit leukocyte function antigen-1 by binding to a novel regulatory integrin site. Nat Med. 2001;7(6):687-92. DOI:10.1038/89058
28. Jain MK, Ridker PM. Anti-inflammatory effects of statins: clinical evidence and basic mechanisms. Nat Rev Drug Discov. 2005;4(12):977-87. DOI:10.1038/nrd1901
29. Fedson DS. Confronting the next influenza pandemic with anti-inflammatory and immunomodulatory agents: why they are needed and how they might work. Influenza Other Respir Viruses. 2009;3(4):129-42. DOI:10.1111/j.1750-2659.2009.00090.x
30. MacIntyre CR, Chughtai AA, Das A, et al. Effect of statin use on the risk of influenza and influenza vaccine effectiveness. Int J Cardiol. 2021;332:205-8. DOI:10.1016/j.ijcard.2021.03.055
31. Chung H, Campitelli MA, Buchan SA, et al. Evaluating the Impact of Statin Use on Influenza Vaccine Effectiveness and Influenza Infection in Older Adults. Clin Infect Dis. 2023;77(2):303-11. DOI:10.1093/cid/ciad148
32. Wu F, Wang C, Li S, et al. Association between Statins Administration and Influenza Susceptibility: A Systematic Review and Meta-Analysis of Longitudinal Studies. Viruses. 2024;16(2):278. DOI:10.3390/v16020278
33. Kwong JC, Li P, Redelmeier DA. Influenza morbidity and mortality in elderly patients receiving statins: a cohort study. PLoS One. 2009;4(11):e8087. DOI:10.1371/journal.pone.0008087
34. Brett SJ, Myles P, Lim WS, et al. Pre-admission statin use and in-hospital severity of 2009 pandemic influenza A (H1N1) disease. PLoS One. 2011;6(4):e18120. DOI:10.1371/journal.pone.0018120
35. Mortensen EM, Nakashima B, Cornell J, et al. Population-based study of statins, angiotensin II receptor blockers, and angiotensin-converting enzyme inhibitors on pneumonia-related outcomes. Clin Infect Dis. 2012;55(11):1466-73. DOI:10.1093/cid/cis733
36. Frost FJ, Petersen H, Tollestrup K, Skipper B. Influenza and COPD mortality protection as pleiotropic, dose-dependent effects of statins. Chest. 2007;131(4):1006-12. DOI:10.1378/chest.06-1997
37. Allen SC, Mamotte CDS. Pleiotropic and Adverse Effects of Statins – Do Epigenetics Play a Role? J Pharmacol Exp Ther. 2017;362(2):319-26. DOI:10.1124/jpet.117.242081
38. Shyr ZA, Cheng YS, Lo DC, et al. Drug combination therapy for emerging viral diseases. Drug Discov Today. 2021;26(10):2367-76. DOI:10.1016/j.drudis.2021.05.008
39. Edwards MR, Johnson MW, Johnston SL. Combination therapy: Synergistic suppression of virus-induced chemokines in airway epithelial cells. Am J Respir Cell Mol Biol. 2006;34(5):616-24. DOI:10.1165/rcmb.2005-0385OC
40. Dunning J, Baillie JK, Cao B, et al. Antiviral combinations for severe influenza. Lancet Infect Dis. 2014;14(12):1259-70. DOI:10.1016/S1473-3099(14)70821-7
41. Johnston CS, Barkyoumb GM, Schumacher SS. Vitamin C supplementation slightly improves physical activity levels and reduces cold incidence in men with marginal vitamin C status: a randomized controlled trial. Nutrients. 2014;6(7):2572-83. DOI:10.3390/nu6072572
42. Sasazuki S, Sasaki S, Tsubono Y, et al. Effect of vitamin C on common cold: randomized controlled trial. Eur J Clin Nutr. 2006;60(1):9-17. DOI:10.1038/sj.ejcn.1602261
43. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;2013(1):CD000980. DOI:10.1002/14651858.CD000980.pub4
44. Padayatty SJ, Levine M. Vitamin C: the known and the unknown and Goldilocks. Oral Dis. 2016;22(6):463-93. DOI:10.1111/odi.12446
45. Горелов А.В., Драпкина О.М., Лобзин Ю.В., и др. Заключение по итогам экспертного совета по новым подходам в лечении и профилактике ОРВИ и гриппа в Российской Федерации. Инфекционные болезни. 2025;23(3):135-42 [Gorelov AV, Drapkina OM, Lobzin IuV, et al. Zakliuchenie po itogam ekspertnogo soveta po novym podkhodam v lechenii i profilaktike ORVI i grippa v Rossiiskoi Federatsii. Infectious Diseases. 2025;23(3):135-42 (in Russian)]. DOI:10.20953/1729-9225-2025-3-135-142

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1. Incze M, Grady D, Gupta A. I Have a Cold – What Do I Need to Know? JAMA Intern Med. 2018;178(9):1288. DOI:10.1001/jamainternmed.2018.2621
2. Witek TJ, Ramsey DL, Carr AN, Riker DK. The natural history of community-acquired common colds symptoms assessed over 4-years. Rhinology. 2015;53(1):81-8. DOI:10.4193/Rhino14.149
3. Kardos P, Malek FA. Common cold – an umbrella term for acute infections of nose, throat, larynx and bronchi. Pneumologie. 2017;71(4):221-6. DOI:10.1055/s-0042-116112
4. Dmitrieva OA, Mironova OIu, Fomin VV. Influenza vaccination and prognosis for patients with high cardiovascular risk. Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(9):1100-5 (in Russian). DOI:10.26442/00403660.2021.09.201023
5. Goldin S, Brooks D, Jorgensen P, et al. Seasonal influenza vaccination: A global review of national policies in 194 WHO member states in 2022. Vaccine. 2024;42:126274 DOI:10.1016/j.vaccine.2024.126274
6. Zaicev AA, Sinopalnikov AI. "Difficult" pneumonia. Terapevticheskii arkhiv (Ter. Arkh.). 2021;93(3):300-10 (in Russian). DOI:10.26442/00403660.2021.03.200734
7. Heidecker B, Libby P, Vassiliou VS, et al. Vaccination as a new form of cardiovascular prevention: a European Society of Cardiology clinical consensus statement. Eur Heart J. 2025;46(36):3518-31. DOI:10.1093/eurheartj/ehaf384
8. Bonomini A, Mercorelli B, Loregian A. Antiviral strategies against influenza virus: an update on approved and innovative therapeutic approaches. Cell Mol Life Sci. 2025;82(1):75. DOI:10.1007/s00018-025-05611-1
9. Ruleva AA, Popova VV, Lyovina AV, et al. Immunological mechanisms of the drug Cytovir®-3 action as the basis of the prevention of acute respiratory viral infections and infl uenza. Immunologiya. 2021;42(2):148-58 (in Russian). DOI:10.33029/0206-4952-2021-42-2-148-158
10. Smirnov VS, Petlenko SV, Krasnov AA, et al. Systemic review and meta-analysis of the three-component drug regimen (alpha-glutamyl-tryptophan, bendazole, ascorbic acid) prophylactic efficacy. Russ J Prev Med. 2025;28(8):48-55 (in Russian). DOI:10.17116/profmed20252808148
11. Karakonstantis S, Lytras T, Keske S, et al. The Care Continuum of Patients With Influenza in the Post-COVID-19 Era: A Position Paper. J Infect Dis. 2025;232(Suppl. 3):S333-46. DOI:10.1093/infdis/jiaf333
12. Ebell MH, Call M, Shinholser J. Effectiveness of oseltamivir in adults: a meta-analysis of published and unpublished clinical trials. Fam Pract. 2013;30(2):125-33. DOI:10.1093/fampra/cms059
13. Michiels B, Van Puyenbroeck K, Verhoeven V, et al. The value of neuraminidase inhibitors for the prevention and treatment of seasonal influenza: a systematic review of systematic reviews. PLoS One. 2013;8(4):e60348. DOI:10.1371/journal.pone.0060348
14. Jefferson T, Jones M, Doshi P, et al. Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ. 2014;348:g2545. DOI:10.1136/bmj.g2545
15. Jefferson T, Jones MA, Doshi P, et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults. Cochrane Database Syst Rev. 2006;(3):CD001265. DOI:10.1002/14651858.CD001265.pub2
16. Okoli GN, Otete HE, Beck CR, et al. Use of neuraminidase inhibitors for rapid containment of influenza: a systematic review and meta-analysis of individual and household transmission studies. PLoS One. 2014;9(12):e113633. DOI:10.1371/journal.pone.0113633
17. Miyashita N. Contemporary Concise Review 2024: Respiratory Infections. Respirology. 2025;30(10):926-34. DOI:10.1111/resp.70113
18. Dobson J, Whitley RJ, Pocock S, et al. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet. 2015;385(9979):1729-37. DOI:10.1016/S0140-6736(14)62449-1
19. Malosh RE, Martin ET, Heikkinen T, et al. Efficacy and Safety of Oseltamivir in Children: Systematic Review and Individual Patient Data Meta-analysis of Randomized Controlled Trials. Clin Infect Dis. 2018;66(10):1492-500. DOI:10.1093/cid/cix1040
20. Hanage WP, Schaffner W. Burden of Acute Respiratory Infections Caused by Influenza Virus, Respiratory Syncytial Virus, and SARS-CoV-2 with Consideration of Older Adults: A Narrative Review. Infect Dis Ther. 2025;14(Suppl. 1):5-37. DOI:10.1007/s40121-024-01080-4
21. Branda F, Petrosillo N, Yon DK, et al. Comprehensive Analysis of Influenza Viruses’ Trends in Italy: Insights from a Nationwide and Regional Perspective. Infect Dis Rep. 2025;17(2):20. DOI:10.3390/idr17020020
22. Kumar D, Ison MG, Mira JP, et al. Combining baloxavir marboxil with standard-of-care neuraminidase inhibitor in patients hospitalised with severe influenza (FLAGSTONE): a randomised, parallel-group, double-blind, placebo-controlled, superiority trial. Lancet Infect Dis. 2022;22(5):718-30. DOI:10.1016/S1473-3099(21)00469-2
23. Hui DS, Lee N, Chan PK, Beigel JH. The role of adjuvant immunomodulatory agents for treatment of severe influenza. Antiviral Res. 2018;150:202-16. DOI:10.1016/j.antiviral.2018.01.002
24. Hui DSC, Chan KKP. Host Immunomodulatory Interventions in Severe Influenza. J Infect Dis. 2025;232(Suppl. 3):S262-72. DOI:10.1093/infdis/jiaf328
25. Vasin AA, Mironova OIu, Fomin VV. The atorvastatin effects on the prevention of contrast-induced acute kidney injury during computed tomography with contrast media. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1057-61 (in Russian). DOI:10.26442/00403660.2022.09.201845
26. Vasin AA, Mironova OIu, Fomin VV. Intravenous contrast induced acute kidney injury prevention with high doses of statins. Eur Card Rev. 2022;(3):84-8 (in Russian). DOI:10.38109/2225-1685-2022-3-84-88
27. Weitz-Schmidt G, Welzenbach K, Brinkmann V, et al. Statins selectively inhibit leukocyte function antigen-1 by binding to a novel regulatory integrin site. Nat Med. 2001;7(6):687-92. DOI:10.1038/89058
28. Jain MK, Ridker PM. Anti-inflammatory effects of statins: clinical evidence and basic mechanisms. Nat Rev Drug Discov. 2005;4(12):977-87. DOI:10.1038/nrd1901
29. Fedson DS. Confronting the next influenza pandemic with anti-inflammatory and immunomodulatory agents: why they are needed and how they might work. Influenza Other Respir Viruses. 2009;3(4):129-42. DOI:10.1111/j.1750-2659.2009.00090.x
30. MacIntyre CR, Chughtai AA, Das A, et al. Effect of statin use on the risk of influenza and influenza vaccine effectiveness. Int J Cardiol. 2021;332:205-8. DOI:10.1016/j.ijcard.2021.03.055
31. Chung H, Campitelli MA, Buchan SA, et al. Evaluating the Impact of Statin Use on Influenza Vaccine Effectiveness and Influenza Infection in Older Adults. Clin Infect Dis. 2023;77(2):303-11. DOI:10.1093/cid/ciad148
32. Wu F, Wang C, Li S, et al. Association between Statins Administration and Influenza Susceptibility: A Systematic Review and Meta-Analysis of Longitudinal Studies. Viruses. 2024;16(2):278. DOI:10.3390/v16020278
33. Kwong JC, Li P, Redelmeier DA. Influenza morbidity and mortality in elderly patients receiving statins: a cohort study. PLoS One. 2009;4(11):e8087. DOI:10.1371/journal.pone.0008087
34. Brett SJ, Myles P, Lim WS, et al. Pre-admission statin use and in-hospital severity of 2009 pandemic influenza A (H1N1) disease. PLoS One. 2011;6(4):e18120. DOI:10.1371/journal.pone.0018120
35. Mortensen EM, Nakashima B, Cornell J, et al. Population-based study of statins, angiotensin II receptor blockers, and angiotensin-converting enzyme inhibitors on pneumonia-related outcomes. Clin Infect Dis. 2012;55(11):1466-73. DOI:10.1093/cid/cis733
36. Frost FJ, Petersen H, Tollestrup K, Skipper B. Influenza and COPD mortality protection as pleiotropic, dose-dependent effects of statins. Chest. 2007;131(4):1006-12. DOI:10.1378/chest.06-1997
37. Allen SC, Mamotte CDS. Pleiotropic and Adverse Effects of Statins – Do Epigenetics Play a Role? J Pharmacol Exp Ther. 2017;362(2):319-26. DOI:10.1124/jpet.117.242081
38. Shyr ZA, Cheng YS, Lo DC, et al. Drug combination therapy for emerging viral diseases. Drug Discov Today. 2021;26(10):2367-76. DOI:10.1016/j.drudis.2021.05.008
39. Edwards MR, Johnson MW, Johnston SL. Combination therapy: Synergistic suppression of virus-induced chemokines in airway epithelial cells. Am J Respir Cell Mol Biol. 2006;34(5):616-24. DOI:10.1165/rcmb.2005-0385OC
40. Dunning J, Baillie JK, Cao B, et al. Antiviral combinations for severe influenza. Lancet Infect Dis. 2014;14(12):1259-70. DOI:10.1016/S1473-3099(14)70821-7
41. Johnston CS, Barkyoumb GM, Schumacher SS. Vitamin C supplementation slightly improves physical activity levels and reduces cold incidence in men with marginal vitamin C status: a randomized controlled trial. Nutrients. 2014;6(7):2572-83. DOI:10.3390/nu6072572
42. Sasazuki S, Sasaki S, Tsubono Y, et al. Effect of vitamin C on common cold: randomized controlled trial. Eur J Clin Nutr. 2006;60(1):9-17. DOI:10.1038/sj.ejcn.1602261
43. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;2013(1):CD000980. DOI:10.1002/14651858.CD000980.pub4
44. Padayatty SJ, Levine M. Vitamin C: the known and the unknown and Goldilocks. Oral Dis. 2016;22(6):463-93. DOI:10.1111/odi.12446
45. Gorelov AV, Drapkina OM, Lobzin IuV, et al. Zakliuchenie po itogam ekspertnogo soveta po novym podkhodam v lechenii i profilaktike ORVI i grippa v Rossiiskoi Federatsii. Infectious Diseases. 2025;23(3):135-42 (in Russian). DOI:10.20953/1729-9225-2025-3-135-142

Авторы

О.Ю. Трушина*

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*mironova_o_yu@staff.sechenov.ru

________________________________________________

Olga Iu. Trushina*

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*mironova_o_yu@staff.sechenov.ru

Назад к списку

Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.