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An Early Test-and-Treat Strategy for Severe Acute Respiratory Syndrome Coronavirus 2
Joshua T Schiffer1,2,3, Christine Johnston1,3, Anna Wald1,3,4,5
1Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Abstract:
As coronavirus disease 2019 cases and deaths continue to expand globally, there is an urgent need to develop, test, and approve effective antiviral therapies. Currently, a majority of clinical trials are evaluating therapies in patients who are already hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection. Given that the median time between development of symptoms and need for hospitalization is 1 week, a golden opportunity to intervene early is being missed. Indeed, for many other viral infections, early treatment soon after development of symptoms is associated with decreased mortality, lower hospitalization rates, and lower likelihood of transmission to others. In this study, we advocate for randomized, double-blind, placebo controlled, clinical trials to evaluate promising agents early during SARS CoV-2 infection.
Insights
Early intervention with antiviral therapies for coronavirus disease 2019 (COVID-19) is crucial. This study advocates for clinical trials to test treatments soon after symptom onset to reduce severe outcomes and transmission.
Area of Science:
- Virology and Infectious Diseases
- Clinical Trial Design
- Antiviral Therapeutics
Background:
- Global expansion of coronavirus disease 2019 (COVID-19) necessitates effective antiviral therapies.
- Current clinical trials predominantly focus on hospitalized patients, missing early intervention opportunities.
- Early treatment for viral infections typically reduces mortality, hospitalization, and transmission.
Purpose of the Study:
- To highlight the missed opportunity for early intervention in COVID-19 treatment.
- To advocate for the initiation of clinical trials evaluating antiviral agents during the early symptomatic phase of SARS-CoV-2 infection.
Main Methods:
- Proposes randomized, double-blind, placebo-controlled clinical trial designs.
- Emphasizes evaluating promising antiviral agents early after symptom development.
Main Results:
- The study did not involve direct patient results but presents a strong rationale for early treatment trials.
- Identifies a critical 1-week window between symptom onset and hospitalization for potential therapeutic intervention.
Conclusions:
- Early administration of antiviral therapies in COVID-19 patients is a critical unmet need.
- Implementing early-stage clinical trials for SARS-CoV-2 is essential to combat the pandemic effectively.
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