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Respiratorische Virusinfektionen

Unter besonderer Berücksichtigung des Severe Acute Respiratory Syndrome Coronavirus 2 und der Influenza-Viren

Respiratory viral infections

Under special consideration of severe acute respiratory syndrome coronavirus 2 and influenza viruses

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Zusammenfassung

Respiratorische Viren verursachen jährlich die höchste Anzahl von Krankheits- und Todesfällen unter allen Infektionserregern. Im vorliegenden Beitrag werden die aktuelle Epidemiologie, Pathogenese, Risikofaktoren und medikamentöse Therapie des Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), der Influenza-Viren, des respiratorischen Synzytialvirus (RSV) und anderer respiratorischer Viren erörtert. Das SARS-CoV‑2 und die Influenza-Viren sind impfpräventabel, und seit 08/2023 steht ein erster Impfstoff gegen RSV zur Verfügung. Bei Infektionen mit dem SARS-CoV‑2 und Influenza-Viren wird zudem eine stadiengerechte (antivirale) medikamentöse Therapie empfohlen. Aufgrund der hohen und landläufig unterschätzten Krankheitslast durch RSV bleibt hier auf künftige antivirale Substanzen zu hoffen. Insbesondere bei Risikopatienten sollte auf ausreichenden Impfstatus gegen respiratorische Erreger geachtet werden, und bei klinischem Verdacht auf eine virale Atemwegsinfektion sollten zeitnah ein Erregernachweis und ggf. eine spezifische Therapie erfolgen. Nachdem effektive Impfungen und Virostatika verfügbar sind, besteht nun die Herausforderung darin, diese für alle Risikopatienten zu nutzen sowie vermeidbare Infektionen, schwere Verläufe und Langzeitfolgen wirklich zu verhindern.

Abstract

Respiratory viruses cause the highest number of morbidities and deaths annually among all infectious pathogens. This article discusses the current epidemiology, pathogenesis, risk factors, and drug treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza viruses, respiratory syncytial virus (RSV), and other respiratory viruses. The SARS-CoV‑2 and influenza are preventable with vaccines and a first vaccine against RSV is available since 08/2023. For infections with SARS-CoV‑2 and influenza, a stage-specific (antiviral) drug treatment is also recommended. Due to the high and commonly underestimated disease burden caused by RSV, it must be hoped that antiviral substances will be found in the future. In patients at risk, particular attention should be paid to an adequate vaccination status against respiratory pathogens and if there is clinical suspicion of a viral airway infection, the pathogen should be promptly identified and, if necessary, specific treatment should be carried out. Now that effective vaccinations and antiviral drugs are available, the challenge is to use them for all patients at risk and thus really prevent avoidable infections, severe courses and long-term sequelae.

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Authors and Affiliations

  1. Universitätsklinikum Gießen und Marburg GmbH, Medizinische Klinik V für Innere Medizin m.S. Infektiologie und Krankenhaushygiene, Justus-Liebig-Universität Gießen, Klinikstr 33, 35392, Gießen, Deutschland

    Janina Trauth

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Correspondence to Janina Trauth.

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Interessenkonflikt

J. Trauth ist als Referentin für die Fa. GSK tätig, an Studiendurchführungen der Fa. Janssen Pharmaceuticals beteiligt und erhält Reise-Sponsoring der Fa. Gilead.

Für diesen Beitrag wurden von der Autorin keine Studien an Menschen oder Tieren durchgeführt.

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Jessica Rademacher, Hannover

Tobias Welte, Hannover

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Trauth, J. Respiratorische Virusinfektionen. Med Klin Intensivmed Notfmed 118, 445–453 (2023). https://doi.org/10.1007/s00063-023-01050-7

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