ArticlePLoS computational biology2021
Success of prophylactic antiviral therapy for SARS-CoV-2: Predicted critical efficacies and impact of different drug-specific mechanisms of action.
Article in PLoS computational biology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 60 citations in OpenAlex.
- Effect of remdesivir on viral dynamics in COVID-19 hospitalized patients: a modelling analysis of the randomized, controlled, open-label DisCoVeRy trial.The Journal of antimicrobial chemotherapy · 2022Trial
- Modeling suggests SARS-CoV-2 rebound after nirmatrelvir-ritonavir treatment is driven by target cell preservation coupled with incomplete viral clearance.Journal of virology · 2025Article
- The kinetics of SARS-CoV-2 infection based on a human challenge study.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Differences in virus and immune dynamics for SARS-CoV-2 Delta and Omicron infections by age and vaccination histories.BMC infectious diseases · 2024Article
- A unifying model to explain frequent SARS-CoV-2 rebound after nirmatrelvir treatment and limited prophylactic efficacy.Nature communications · 2024Article
- A unifying model to explain high nirmatrelvir therapeutic efficacy against SARS-CoV-2, despite low post-exposure prophylaxis efficacy and frequent viral rebound.medRxiv : the preprint server for health sciences · 2024Article
- Article
- Public Health Impact of Paxlovid as Treatment for COVID-19, United States.Emerging infectious diseases · 2024Article
- The reproduction number and its probability distribution for stochastic viral dynamics.Journal of the Royal Society, Interface · 2024Article
- The effect of random virus failure following cell entry on infection outcome and the success of antiviral therapy.Scientific reports · 2023Article
- SARS-CoV-2 viral dynamic modeling to inform model selection and timing and efficacy of antiviral therapy.CPT: pharmacometrics & systems pharmacology · 2023Article
- Making waves: Integrating wastewater surveillance with dynamic modeling to track and predict viral outbreaks.Water research · 2023Article
- Synthesis of bis-furyl-pyrrolo[3,4-RSC medicinal chemistry · 2023Article
- Oral mucosa immunity: ultimate strategy to stop spreading of pandemic viruses.Frontiers in immunology · 2023Review
- Eigenvalue analysis of SARS-CoV-2 viral load data: illustration for eight COVID-19 patients.International journal of data science and analytics · 2023Article
- Treatment of Respiratory Viral Coinfections.Epidemiologia (Basel, Switzerland) · 2022Article
- Modelling upper respiratory viral load dynamics of SARS-CoV-2.BMC medicine · 2022Article
- Therapeutic interfering particles exploiting viral replication and assembly mechanisms show promising performance: a modelling study.Scientific reports · 2021Article
- In vivo kinetics of SARS-CoV-2 infection and its relationship with a person's infectiousness.Proceedings of the National Academy of Sciences of the United States of America · 2021Article
- Numerical approaches for the rapid analysis of prophylactic efficacy against HIV with arbitrary drug-dosing schemes.PLoS computational biology · 2021Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
Repurposed drugs that are safe and immediately available constitute a first line of defense against new viral infections. Despite limited antiviral activity against SARS-CoV-2, several drugs are being tested as medication or as prophylaxis to prevent infection. Using a stochastic model of early phase infection, we evaluate the success of prophylactic treatment with different drug types to prevent viral infection. We find that there exists a critical efficacy that a treatment must reach in order to block viral establishment. Treatment by a combination of drugs reduces the critical efficacy, most effectively by the combination of a drug blocking viral entry into cells and a drug increasing viral clearance. Below the critical efficacy, the risk of infection can nonetheless be reduced. Drugs blocking viral entry into cells or enhancing viral clearance reduce the risk of infection more than drugs that reduce viral production in infected cells. The larger the initial inoculum of infectious virus, the less likely is prevention of an infection. In our model, we find that as long as the viral inoculum is smaller than 10 infectious virus particles, viral infection can be prevented almost certainly with drugs of 90% efficacy (or more). Even when a viral infection cannot be prevented, antivirals delay the time to detectable viral loads. The largest delay of viral infection is achieved by drugs reducing viral production in infected cells. A delay of virus infection flattens the within-host viral dynamic curve, possibly reducing transmission and symptom severity. Thus, antiviral prophylaxis, even with reduced efficacy, could be efficiently used to prevent or alleviate infection in people at high risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.