INTRODUCTION The upper respiratory tract is a major route of infection for COVID-19 and other respiratory diseases. Thus, it appears logical to exploit the nose as administration site to prevent, fight, or minimize infectious spread and treat the disease. Numerous nasal products addressing these aspects have been considered and developed for COVID-19. AREAS COVERED This review gives a comprehensive overview of the different approaches involving nasal delivery, i.e., nasal vaccination, barrier products, and antiviral pharmacological treatments that have led to products on the market or under clinical evaluation, highlighting the peculiarities of the nose as application and absorption site and pointing at key aspects of nasal drug delivery. EXPERT OPINION From the analysis of nasal delivery strategies to prevent or fight COVID-19, it emerges that, especially for nasal immunization, formulations appear the same as originally designed for parenteral administration, leading to suboptimal results. On the other hand, mechanical barrier and antiviral products, designed to halt or treat the infection at early stage, have been proven effective but were rarely brought to the clinics. If supported by robust and targeted product development strategies, intranasal immunization and drug delivery can represent valid and sometimes superior alternatives to more conventional parenteral and oral medications.

中文翻译：

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鼻腔给药作为预防和治疗 COVID-19 的策略。

简介 上呼吸道是 COVID-19 和其他呼吸道疾病的主要感染途径。因此，利用鼻子作为给药部位来预防、对抗或最小化感染传播并治疗疾病似乎是合乎逻辑的。针对 COVID-19，已经考虑并开发了许多针对这些方面的鼻腔产品。涵盖的领域 本综述全面概述了涉及鼻腔给药的不同方法，即鼻腔疫苗接种、屏障产品和抗病毒药物治疗，这些方法导致产品上市或正在进行临床评估，强调了鼻腔作为应用和治疗的特殊性。吸收位点并指出鼻腔药物输送的关键方面。专家意见 通过对预防或对抗 COVID-19 的鼻腔给药策略的分析发现，特别是对于鼻腔免疫，配方似乎与最初设计用于肠胃外给药的配方相同，导致结果不理想。另一方面，旨在早期阻止或治疗感染的机械屏障和抗病毒产品已被证明是有效的，但很少被带到诊所。如果得到强有力和有针对性的产品开发策略的支持，鼻内免疫和药物输送可以代表更传统的肠胃外和口服药物的有效且有时是更好的替代方案。