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
Issued Date
2022-01-01
Resource Type
ISSN
10584838
eISSN
15376591
Scopus ID
2-s2.0-85134490077
Pubmed ID
34549260
Journal Title
Clinical Infectious Diseases
Volume
75
Issue
1
Start Page
E224
End Page
E233
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Infectious Diseases Vol.75 No.1 (2022) , E224-E233
Suggested Citation
Whittaker C. 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. Clinical Infectious Diseases Vol.75 No.1 (2022) , E224-E233. E233. doi:10.1093/cid/ciab837 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86329
Title
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
Author(s)
Author's Affiliation
Siriraj Hospital
Faculty of Tropical Medicine, Mahidol University
Oxford University Clinical Research Unit
Imperial College Healthcare NHS Trust
Universidad de las Americas - Ecuador
Bangkok Christian Hospital
Universidad Javeriana Facultad de Medicina
University Teaching Hospital Lusaka
University of Zambia School of Medicine
Universitas Gadjah Mada
Universitas Indonesia
Ministry of Health Nairobi
Universidad Nacional de Colombia, Facultad de Medicina
Faculdade de Medicina de Sao Jose do Rio Preto
Hospital Universitario San Ignacio
Universidad Central de Venezuela, Facultad de Ciencias
Universidade Estadual de Campinas
University of Oxford
P.D. Hinduja National Hospital and Medical Research Centre
University College London
Imperial College Faculty of Medicine
Thailand Ministry of Public Health
Imperial College London
Universidade Federal de Mato Grosso do Sul
Nuffield Department of Medicine
Universidade de São Paulo
Instituto Venezolano de Investigaciones Cientificas
Yale University
Kenyan Ministry of Health
Oswaldo Cruz Foudantion
Biomedical Research and Therapeutic Vaccines Institute
Samutprakan Hospital
Hospital 'Prof. Bernardo Houssay'
Faculty of Tropical Medicine, Mahidol University
Oxford University Clinical Research Unit
Imperial College Healthcare NHS Trust
Universidad de las Americas - Ecuador
Bangkok Christian Hospital
Universidad Javeriana Facultad de Medicina
University Teaching Hospital Lusaka
University of Zambia School of Medicine
Universitas Gadjah Mada
Universitas Indonesia
Ministry of Health Nairobi
Universidad Nacional de Colombia, Facultad de Medicina
Faculdade de Medicina de Sao Jose do Rio Preto
Hospital Universitario San Ignacio
Universidad Central de Venezuela, Facultad de Ciencias
Universidade Estadual de Campinas
University of Oxford
P.D. Hinduja National Hospital and Medical Research Centre
University College London
Imperial College Faculty of Medicine
Thailand Ministry of Public Health
Imperial College London
Universidade Federal de Mato Grosso do Sul
Nuffield Department of Medicine
Universidade de São Paulo
Instituto Venezolano de Investigaciones Cientificas
Yale University
Kenyan Ministry of Health
Oswaldo Cruz Foudantion
Biomedical Research and Therapeutic Vaccines Institute
Samutprakan Hospital
Hospital 'Prof. Bernardo Houssay'
Other Contributor(s)
Abstract
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.