PMID- 35945513 OWN - NLM STAT- MEDLINE DCOM- 20220811 LR - 20231101 IS - 1471-2334 (Electronic) IS - 1471-2334 (Linking) VI - 22 IP - 1 DP - 2022 Aug 9 TI - Could widespread use of antiviral treatment curb the COVID-19 pandemic? A modeling study. PG - 683 LID - 10.1186/s12879-022-07639-1 [doi] LID - 683 AB - 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. CI - (c) 2022. The Author(s). FAU - Matrajt, Laura AU - Matrajt L AUID- ORCID: 0000-0003-4495-7245 AD - Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, USA. laurama@fredhutch.org. AD - Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA. laurama@fredhutch.org. FAU - Brown, Elizabeth R AU - Brown ER AD - Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, USA. AD - Department of Biostatistics, University of Washington, Seattle, USA. AD - Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA. FAU - Cohen, Myron S AU - Cohen MS AD - Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, USA. AD - Department of Biostatistics, University of Washington, Seattle, USA. AD - Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA. FAU - Dimitrov, Dobromir AU - Dimitrov D AD - Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, USA. AD - Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA. AD - Department of Applied Mathematics, University of Washington, Seattle, USA. FAU - Janes, Holly AU - Janes H AD - Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, USA. AD - Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA. LA - eng GR - R56AI143418/NH/NIH HHS/United States GR - S10 OD028685/OD/NIH HHS/United States GR - UM1 AI068635/NH/NIH HHS/United States GR - R01CA152089/NH/NIH HHS/United States GR - UM1 AI148684/AI/NIAID NIH HHS/United States GR - NU38OT000297/CC/CDC HHS/United States GR - R01 CA152089/CA/NCI NIH HHS/United States GR - S10OD028685/NH/NIH HHS/United States GR - NU38OT000297-02/CC/CDC HHS/United States GR - UM1 AI068635/AI/NIAID NIH HHS/United States GR - UM1AI148684/NH/NIH HHS/United States GR - UM1AI068619/NH/NIH HHS/United States GR - P30AI050410/NH/NIH HHS/United States GR - P30 AI050410/AI/NIAID NIH HHS/United States GR - UM1 AI068617/AI/NIAID NIH HHS/United States PT - Journal Article DEP - 20220809 PL - England TA - BMC Infect Dis JT - BMC infectious diseases JID - 100968551 RN - 0 (Antiviral Agents) SB - IM UOF - medRxiv. 2022 Apr 04;:. PMID: 34790985 MH - Adult MH - Aged MH - Antiviral Agents/therapeutic use MH - *COVID-19/prevention & control MH - Hospitalization MH - Humans MH - Pandemics/prevention & control MH - SARS-CoV-2 MH - United States MH - *COVID-19 Drug Treatment PMC - PMC9361252 OTO - NOTNLM OT - Agent-based model OT - Antiviral treatment OT - COVID-19 OT - Mathematical model OT - SARS-CoV-2 COIS- The authors declare that they have no competing interests. EDAT- 2022/08/10 06:00 MHDA- 2022/08/12 06:00 PMCR- 2022/08/09 CRDT- 2022/08/09 23:35 PHST- 2022/04/28 00:00 [received] PHST- 2022/07/20 00:00 [accepted] PHST- 2022/08/09 23:35 [entrez] PHST- 2022/08/10 06:00 [pubmed] PHST- 2022/08/12 06:00 [medline] PHST- 2022/08/09 00:00 [pmc-release] AID - 10.1186/s12879-022-07639-1 [pii] AID - 7639 [pii] AID - 10.1186/s12879-022-07639-1 [doi] PST - epublish SO - BMC Infect Dis. 2022 Aug 9;22(1):683. doi: 10.1186/s12879-022-07639-1.