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Multicenter Study
. 2020 Sep;9(9):509-514.
doi: 10.1002/psp4.12543. Epub 2020 Aug 7.

Timing of Antiviral Treatment Initiation is Critical to Reduce SARS-CoV-2 Viral Load

Antonio Gonçalves  1 , Julie Bertrand  1 , Ruian Ke  2 , Emmanuelle Comets  1 , Xavier de Lamballerie  3 , Denis Malvy  4   5 , Andrés Pizzorno  6 , Olivier Terrier  6 , Manuel Rosa Calatrava  6 , France Mentré  1 , Patrick Smith  7 , Alan S Perelson  2 , Jérémie Guedj  1
Affiliations
Multicenter Study

Timing of Antiviral Treatment Initiation is Critical to Reduce SARS-CoV-2 Viral Load

Antonio Gonçalves et al. CPT Pharmacometrics Syst Pharmacol. 2020 Sep.

Abstract

We modeled the viral dynamics of 13 untreated patients infected with severe acute respiratory syndrome-coronavirus 2 to infer viral growth parameters and predict the effects of antiviral treatments. In order to reduce peak viral load by more than two logs, drug efficacy needs to be > 90% if treatment is administered after symptom onset; an efficacy of 60% could be sufficient if treatment is initiated before symptom onset. Given their pharmacokinetic/pharmacodynamic properties, current investigated drugs may be in a range of 6-87% efficacy. They may help control virus if administered very early, but may not have a major effect in severely ill patients.

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Conflict of interest statement

J.G. has consulted for F. Hoffman‐La Roche. All other authors declared no competing interests for this work.

Figures

Figure 1
Figure 1
Individual predictions of severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) of 13 untreated patients from Young et al. 3
Figure 2
Figure 2
Reduction in viral load at day 5 post‐symptom onset according to the level of antiviral effectiveness of a treatment blocking the viral production and the timing of treatment initiation (a) at time of infection; (b) at time of symptom onset; (c) 3days after symptom onset). We assumed an incubation period of 5 days.
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References

    1. Cao, B. et al A trial of lopinavir‐ritonavir in adults hospitalized with severe Covid‐19. N. Engl. J. Med. 382, 1787–1799 (2020). - PMC - PubMed
    1. Friberg, L.E. & Guedj, J. Acute bacterial or viral infection—What’s the difference? A perspective from PKPD modellers. Clin. Microbiol. Infect. 10.1016/j.cmi.2019.12.008. [e‐pub ahead of print]. - DOI - PubMed
    1. Young, B.E. et al Epidemiologic features and clinical course of patients infected with SARS‐CoV‐2 in Singapore. JAMA. 10.1001/jama.2020.3204. [e‐pub ahead of print]. - DOI - PMC - PubMed
    1. Zou, L. et al SARS‐CoV‐2 viral load in upper respiratory specimens of infected patients. N. Engl. J. Med. 382, 1177–1179 (2020). - PMC - PubMed
    1. Lauer, S.A. et al The incubation period of coronavirus disease 2019 (COVID‐19) from publicly reported confirmed cases: estimation and application. Ann. Intern. Med. 172, 577–582 (2020). - PMC - PubMed

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