Title :

Association between SARS‐CoV‐2 viral kinetics and clinical score evolution in hospitalized patients

Author(s) :

Néant, Nadège [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Lingas, Guillaume [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Gaymard, Alexandre [Auteur]
Centre National de Référence des Virus des Infections Respiratoires (dont la Grippe) [Lyon] [CNR - laboratoire associé]
Virpath-Grippe, de l'émergence au contrôle -- Virpath-Influenza, from emergence to control [CIRI] [Virpath]
Belhadi, Drifa [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Département d'épidémiologie, biostatistique et recherche clinique
Hites, Maya [Auteur]
Université libre de Bruxelles [ULB]
Staub, Thérèse [Auteur]
Centre Hospitalier de Luxembourg [Luxembourg] [CHL]
Greil, Richard [Auteur]
Paiva, Jose‐Artur [Auteur]
Hospital de São João [Porto]
Universidade do Porto = University of Porto
Poissy, Julien [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Peiffer‐Smadja, Nathan [Auteur]
Services de Maladies Infectieuses et Tropicales [CHU Bichat]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Imperial College London
Costagliola, Dominique [Auteur]
Institut National de la Santé et de la Recherche Médicale [INSERM]
Yazdanpanah, Yazdan [Auteur]
Service des maladies infectieuses et tropicales
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Bouscambert‐Duchamp, Maude [Auteur]
Centre National de Référence des Virus des Infections Respiratoires (dont la Grippe) [Lyon] [CNR - laboratoire associé]
Gagneux‐Brunon, Amandine [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Université Jean Monnet - Saint-Étienne [UJM]
Ader, Florence [Auteur]
Service des Maladies Infectieuses et Tropicales [Lyon]
Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL]
Mentré, France [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Wallet, Florent [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Burdet, Charles [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Département d'épidémiologie, biostatistique et recherche clinique
Guedj, Jérémie [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]

Journal title :

CPT: Pharmacometrics & Systems Pharmacology

Abbreviated title :

CPT Pharmacom & Syst Pharma

Volume number :

1212

Pages :

2027-2037

Publisher :

Wiley

Publication date :

2023-10-11

ISSN :

2163-8306

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

AbstractThe role of antiviral treatment in coronavirus disease 2019 hospitalized patients is controversial. To address this question, we analyzed simultaneously nasopharyngeal viral load and the National Early Warning Score ...
Show more >AbstractThe role of antiviral treatment in coronavirus disease 2019 hospitalized patients is controversial. To address this question, we analyzed simultaneously nasopharyngeal viral load and the National Early Warning Score 2 (NEWS‐2) using an effect compartment model to relate viral dynamics and the evolution of clinical severity. The model is applied to 664 hospitalized patients included in the DisCoVeRy trial (NCT04315948; EudraCT 2020‐000936‐23) randomly assigned to either standard of care (SoC) or SoC + remdesivir. Then we use the model to simulate the impact of antiviral treatments on the time to clinical improvement, defined by a NEWS‐2 score lower than 3 (in patients with NEWS‐2 <7 at hospitalization) or 5 (in patients with NEWS‐2 ≥7 at hospitalization), distinguishing between patients with low or high viral load at hospitalization. The model can fit well the different observed patients trajectories, showing that clinical evolution is associated with viral dynamics, albeit with large interindividual variability. Remdesivir antiviral activity was 22% and 78% in patients with low or high viral loads, respectively, which is not sufficient to generate a meaningful effect on NEWS‐2. However, simulations predicted that antiviral activity greater than 99% could reduce by 2 days the time to clinical improvement in patients with high viral load, irrespective of the NEWS‐2 score at hospitalization, whereas no meaningful effect was predicted in patients with low viral loads. Our results demonstrate that time to clinical improvement is associated with time to viral clearance and that highly effective antiviral drugs could hasten clinical improvement in hospitalized patients with high viral loads.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CNRS

Collections :

• Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576

Research team(s) :

Glycobiology in fungal Pathogenesis and Clinical Applications

Submission date :

2024-03-01T10:46:27Z
2024-03-05T09:40:45Z