Could widespread use of antiviral treatment curb the COVID-19 pandemic? A modeling study
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Abstract
Background
Despite the development of safe and effective vaccines, effective treatments for COVID-19 disease are still urgently needed. Several antiviral drugs have shown to be effective in reducing progression of COVID-19 disease.
Methods
In the present work, we use an agent-based mathematical model to assess the potential population impact of the use of antiviral treatments in four countries with different demographic structure and current levels of vaccination coverage: Kenya, Mexico, United States (US) and Belgium. We analyzed antiviral effects on reducing hospitalization and death, and potential antiviral effects on reducing transmission. For each country, we varied daily treatment initiation rate (DTIR) and antiviral effect in reducing transmission (AVT).
Results
Irrespective of location and AVT, widespread antiviral treatment of symptomatic adult infections (20% DTIR) prevented the majority of COVID-19 deaths, and recruiting 6% of all adult symptomatic infections daily reduced mortality by over 20% in all countries. Furthermore, our model projected that targeting antiviral treatment to the oldest age group (65 years old and older, DTIR of 20%) can prevent over 30% of deaths. Our results suggest that early antiviral treatment (as soon as possible after inception of infection) is needed to mitigate transmission, preventing 50% more infections compared to late treatment (started 3 to 5 days after symptoms onset). Our results highlight the synergistic effect of vaccination and antiviral treatment: as the vaccination rate increases, antivirals have a larger relative impact on population transmission. Finally, our model projects that even in highly vaccinated populations, adding antiviral treatment can be extremely helpful to mitigate COVID-19 deaths.
Conclusions
These results suggest that antiviral treatments can become a strategic tool that, in combination with vaccination, can significantly reduce COVID-19 hospitalizations and deaths and can help control SARS-CoV-2 transmission.
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SciScore for 10.1101/2021.11.10.21266139: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our model, like all mathematical models, is subject to several limitations. We did not consider the development of antiviral resistance, yet it is possible that if antiviral treatments are widely used, resistance could rapidly develop. We analyzed the use of antiviral treatment in symptomatic individuals, and did not explore its use in asymptomatic infections or as a prophylaxis. Further, we assumed that an antiviral effect reducing viral load …
SciScore for 10.1101/2021.11.10.21266139: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our model, like all mathematical models, is subject to several limitations. We did not consider the development of antiviral resistance, yet it is possible that if antiviral treatments are widely used, resistance could rapidly develop. We analyzed the use of antiviral treatment in symptomatic individuals, and did not explore its use in asymptomatic infections or as a prophylaxis. Further, we assumed that an antiviral effect reducing viral load was independent of when treatment was started (as long as it started within the first five days of treatment). In reality, it is possible that antiviral treatments might different effects in reducing viral load at different times, e.g. reducing peak viral load early on but having only a modest effect as time goes by. For simplicity, we did not include waning immunity, but there are increasing reports that both vaccine-induced and infection-induced immunity might wane in a few months. We assumed that the vaccine had no effect in reducing infectiousness, but if vaccination does reduce infectiousness then the synergy between antiviral and vaccine might be less than reported here. We assumed no further vaccination during the period of our analysis, which corresponds to the current situation in most middle- and high-vaccinated countries, where the adult population who are willing to be vaccinated has already been immunized. Nevertheless, the recent approval of the Pfizer vaccine for children aged 5 to 11 years old will change that, immediate...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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