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

• Published in: CPT: Pharmacometrics & Systems Pharmacology Vol. 9; no. 9; pp. 509 - 514
• Main Authors: Gonçalves, Antonio, Bertrand, Julie, Ke, Ruian, Comets, Emmanuelle, Lamballerie, Xavier, Malvy, Denis, Pizzorno, Andrés, Terrier, Olivier, Rosa Calatrava, Manuel, Mentré, France, Smith, Patrick, Perelson, Alan S., Guedj, Jérémie
• Format: Journal Article Web Resource
• Language: English
• Published: United States John Wiley & Sons, Inc 01.09.2020; American Society for Clinical Pharmacology and Therapeutics ; International Society of Pharmacometrics; Wiley; John Wiley and Sons Inc
• Subjects: 60 APPLIED LIFE SCIENCES; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Coronaviruses; COVID-19 - drug therapy; Drug dosages; Hospitalization; Humans; Infections; Life Sciences; Lopinavir - pharmacology; Lopinavir - therapeutic use; Models, Theoretical; Pharmacodynamics; Pharmacokinetics; Plasma; Polymerase chain reaction; Ritonavir - pharmacology; Ritonavir - therapeutic use; SARS-CoV-2 - drug effects; SARS-CoV-2 - physiology; Sensitivity analysis; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Singapore; Treatment Outcome; Viral infections; Viral Load - drug effects; Singapore; France
• ISSN: 2163-8306; 2163-8306
• DOI: 10.1002/psp4.12543

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.