在住院患者中,SARS-CoV-2病毒动力学与临床得分演变之间的关联
Nadège Néant1, Guillaume Lingas1, Alexandre Gaymard2,3
1IAME, Université Paris Cité, IAME, Inserm, F-75018, Paris, France.
CPT: pharmacometrics & systems pharmacology
|September 20, 2023
概括
住院COVID-19患者抗病毒治疗的有效性取决于病毒载量. 高效药物 (>99%) 在高病毒载量患者中可以加快恢复,但在低病毒载量患者中不能.
科学领域:
- 病毒学 病毒学
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 在住院的冠状病毒病2019 (COVID-19) 患者中抗病毒疗法的作用仍在争论中.
- COVID-19的临床严重性演变与病毒动态有关,但患者的反应有很大的不同.
研究的目的:
- 为了研究病毒载量,临床严重程度 (使用国家早期预警分数2 - NEWS-2) 和住院COVID-19患者的抗病毒治疗疗效之间的关系.
- 模拟抗病毒干预对临床改善的及时影响.
主要方法:
- 使用效应区模型分析了来自DisCoVeRy试验的664名住院患者的鼻病毒载量和NEWS-2分数.
- 患者接受了标准护理 (SoC) 或SoC+remdesivir.
- 模拟探索了不同抗病毒活性对临床改善的时间的影响,根据初始病毒载量分层.
主要成果:
- 临床改善与病毒动态相关,显示了实质性的个人间变异性.
- 雷梅西维尔在低病毒载量患者中表现出22%的活性,在高病毒载量患者中表现出78%的活性,不足以显著影响NEWS-2.
- 模拟表明,99%以上的抗病毒活性可以在高病毒载量患者中将临床改善的时间缩短2天,而在低病毒载量病例中没有显著影响.
结论:
- 在COVID-19中临床改善的时间与病毒清除的时间有关.
- 高效抗病毒药物 (>99%的疗效) 具有加速高病毒载荷住院患者临床康复的潜力.
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