Understanding the Potential Impact of Different Drug Properties on Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission and Disease Burden: A Modelling Analysis

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art_WHITTAKER_Understanding_the_Potential_Impact_of_Different_Drug_Properties_2022.PDF (790.85 KB)
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS INC
Autores
WHITTAKER, Charles
WATSON, Oliver J.
ALVAREZ-MORENO, Carlos
ANGKASEKWINAI, Nasikarn
BOONYASIRI, Adhiratha
TRIANA, Luis Carlos
CHANDA, Duncan
CHAROENPONG, Lantharita
CHAYAKULKEEREE, Methee
COOKE, Graham S.
Citação
CLINICAL INFECTIOUS DISEASES, v.75, n.1, p.E224-E233, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Coronavirus disease 2019 (COVID-19) drug development to date has focused on reducing deaths among hospitalized patients, but greater public-health impact could come from drugs delivered to outpatients early in the course of disease, and that prevent hospitalization and/or onwards transmission. Background The public health impact of the coronavirus disease 2019 (COVID-19) pandemic has motivated a rapid search for potential therapeutics, with some key successes. However, the potential impact of different treatments, and consequently research and procurement priorities, have not been clear. Methods Using a mathematical model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, COVID-19 disease and clinical care, we explore the public-health impact of different potential therapeutics, under a range of scenarios varying healthcare capacity, epidemic trajectories; and drug efficacy in the absence of supportive care. Results The impact of drugs like dexamethasone (delivered to the most critically-ill in hospital and whose therapeutic benefit is expected to depend on the availability of supportive care such as oxygen and mechanical ventilation) is likely to be limited in settings where healthcare capacity is lowest or where uncontrolled epidemics result in hospitals being overwhelmed. As such, it may avert 22% of deaths in high-income countries but only 8% in low-income countries (assuming R = 1.35). Therapeutics for different patient populations (those not in hospital, early in the course of infection) and types of benefit (reducing disease severity or infectiousness, preventing hospitalization) could have much greater benefits, particularly in resource-poor settings facing large epidemics. Conclusions Advances in the treatment of COVID-19 to date have been focused on hospitalized-patients and predicated on an assumption of adequate access to supportive care. Therapeutics delivered earlier in the course of infection that reduce the need for healthcare or reduce infectiousness could have significant impact, and research into their efficacy and means of delivery should be a priority.
Palavras-chave
SARS-CoV-2, COVID-19, epidemiology, therapeutics, modelling
URI
https://observatorio.fm.usp.br/handle/OPI/49243
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - COVID-19
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/46
Artigos e Materiais de Revistas Científicas - LIM/49
Artigos e Materiais de Revistas Científicas - ODS/03