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Understanding the Potential Impact of Different Drug Properties On SARS-CoV-2 Transmission and Disease Burden: A Modelling Analysis

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Title: Understanding the Potential Impact of Different Drug Properties On SARS-CoV-2 Transmission and Disease Burden: A Modelling Analysis
Authors: Whittaker, C
Watson, O
Alvarez-Moreno, C
Angkasekwinai, N
Boonyasiri, A
Triana, LC
Chanda, D
Charoenpong, L
Chayakulkeeree, M
Cooke, G
Croda, J
Cucunubá, ZM
Djaafara, A
Estofolete, CF
Grillet, M-E
Faria, N
Costa, SF
Forero-Peña, DA
Gibb, DM
Gordon, A
Hamers, RL
Hamlet, A
Irawany, V
Jitmuang, A
Keurueangkul, N
Kimani, TN
Lampo, M
Levin, A
Lopardo, G
Mustafa, R
Nayagam, AS
Ngamprasertchai, T
Njeri, NIH
Nogueira, ML
Ortiz-Prado, E
Perroud Jr., MW
Phillips, AN
Promsin, P
Qavi, A
Rodger, AJ
Sabino, EC
Sangkaew, S
Sari, D
Sirijatuphat, R
Sposito, AC
Srisangthong, P
Thompson, H
Udwadia, Z
Valderrama-Beltrán, S
Winskill, P
Ghani, A
Walker, P
Hallett, T
Item Type: Journal Article
Abstract: Background The public health impact of the 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 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 hospitalisation) 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 focussed on hospitalised-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.
Issue Date: 1-Jul-2022
Date of Acceptance: 16-Sep-2021
URI: http://hdl.handle.net/10044/1/91886
DOI: 10.1093/cid/ciab837
ISSN: 1058-4838
Publisher: Oxford University Press
Start Page: e224
End Page: e233
Journal / Book Title: Clinical Infectious Diseases
Volume: 75
Issue: 1
Copyright Statement: © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: Medical Research Council (MRC)
Medical Research Council-São Paulo Research Foundation (FAPESP)
Wellcome Trust
Funder's Grant Number: MR/R015600/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Cost of Illness
Pharmaceutical Preparations
Pharmaceutical Preparations
Cost of Illness
06 Biological Sciences
11 Medical and Health Sciences
Publication Status: Published
Online Publication Date: 2021-09-21
Appears in Collections:Department of Surgery and Cancer
Department of Infectious Diseases
Faculty of Medicine
Imperial College London COVID-19
School of Public Health

This item is licensed under a Creative Commons License Creative Commons