In a recent study published in the journal Emerging Infectious Diseases, researchers used insights from a large clinical trial (1,120 cases, 1,126 controls) to simulate 24 different scenarios in which the use of the antiviral drug “Paxlovid,” developed by Pfizer, could benefit. the medical and economic sectors of the United States of America. Their analyzes found that treating just 20% of COVID-19 patients in the country can result in years of life lost (YLL) and financial savings of between $0. 28 million and $0. 85 million. between $56. 95 billion and $170. 17 billion, respectively, for patients with a low and high standard of living. -Transmission scenarios. These findings suggest the use of the drug to counteract the effects of the disease in the US population.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19), undoubtedly the worst pandemic in American memory. The viral infection has already surpassed the 1 million death toll and cost the US people billions in unprecedented infrastructure and economic loss. The advent of messenger RNA (mRNA) vaccinations against the disease and the implementation of social distancing restrictions significantly hampered the spread of the disease but did little to treat the millions of patients already burdened with COVID-19 infections.
Antiviral drugs have shown great promise in treating individuals with viral ailments, most notably in the case of antiretroviral therapy against human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Historically, oseltamivir, an antiviral used against the 2009 influenza A (H1N1) pandemic, is estimated to have saved 63% of hospitalizations. Paxlovid, a Pfizer-developed antiviral, has the potential for even greater years of lives lost (YLL) and economic savings for the US. The drug, a combination of nirmatrelvir and ritonavir, two antivirals with clinically proven anti-COVID-19 efficacy, received Food and Drug Administration (FDA) Emergency Use Authorization on December 22, 2021.
Research into the benefits of Paxlovid has found that “treating symptomatic COVID-19 patients with Paxlovid reduces the risk of hospitalization by approximately 0. 59 for adults aged 18 to 49 years, 0. 40 for adults aged 50 to 64 years, and 0. 53 for adults. “>. 64 years. ” Most encouragingly, Paxlovid has been shown to be effective against Omicron subvariants, which are responsible for the highest existing global burden of COVID-19 and the most competitive clade of SARS-COV-2 to date. However, predictions about the true benefits of this drug are still insufficient.
In the existing study, researchers used knowledge from a cohort of more than 2200 COVID-19 patients to analyze the population-level benefits of Paxlovid. They then built models of viral replication within the host to simulate 24 distinct scenarios of COVID-19 transmission. .
Data for the study comprised individual patient viral loads from a Paxlovid clinical trial, including 1,120 cases receiving Paxlovid and 1,126 controls receiving a placebo. The data was used to reveal 1. infection rates of susceptible cells (b), 2. the rate at which infected cells die (c), 3. the virus production rate (p), and the efficacy of Paxlovid at suppressing viral replication (). A stochastic approximation expectation-maximization algorithm was used to improve simulation accuracy.
“Based on previous studies, we hypothesized that a person’s contagion is logarithmically similar to their viral titer (Appendix). In this transmission model, we assume that a patient’s daily infection depends on whether or not they got treatment and, if so, when they recovered. It started after the onset of symptoms.
To further improve the real-world application of the models, the simulations were tuned to 9,961 persons living in 5,000 households whose sociodemographic data was acquired from the National Household Travel Survey (2017). Results from Paxlovid versus no intervention were used to compute YLL averted metrics and monetary savings.
The results of the study revealed that the mean rate of viral infections of vulnerable cells was 3. 92 x 10-6 mL/copies/day, clearance rates were 0. 62 per day, and production rates were 3. 19 mL/copies/day. Surprisingly, Paxlovid remedy suppresses 99. 37% of viral replication.
Of the 24 simulated transmission scenarios, the low (reproduction number = 1. 2) and higher (number = 3) transmission scenarios revealed AVP aversions of between 0. 28 and 0. 85 million patients and economic savings of between $56. 95 billion and $170. 17 billion if even 20% COVID coverage is exceeded. -19 patients were treated with this antiviral drug.
Distinguishing between the direct (therapeutic) and oblique (reducing transmission) benefits of Paxlovid, the researchers found that over three hundred days, Paxlovid’s early interventions can reduce COVID-19 mortality by 16,470 cases and save 140,000 hospitalizations. The indirect benefits matched the direct benefits and are also expected to particularly reduce infection rates to 10. 57 million or more.
“We would expect mass treatment campaigns to have even greater health and economic effects in countries that have followed zero-COVID methods and therefore have lower degrees of population-level immunity than the United States. “
The supply study highlights the benefits to human life and economic savings that antivirals like Paxlovid can bring in the fight against COVID-19. Analysis and simulation of data from more than 2,200 patients revealed that treating just 20% of the affected population with this drug could save 0. 85 million patients and save 140,000 hospitalizations per day, reducing the economic burden by $170. 17 billion or more.
“Drugs like Paxlovid can particularly lessen the severity of COVID-19 and enable a global transition to manageable coexistence with the virus. However, offering equitable and effective global access to antiviral drugs for SARS-CoV-2 would require sufficient materials and large quantities of testing and remediation programs at scale.
Written by
Hugo Francisco de Souza is a scientific publisher founded in Bangalore, Karnataka, India. Her educational passions lie in biogeography, evolutionary biology, and herpetology. He is recently pursuing his PhD at the Centre for Ecological Sciences of the Indian Institute of Science, where he studies the origins, dispersal and speciation of snakes related to wetlands. Hugo received, among others, the DST-INSPIRE scholarship for his doctoral studies and the gold medal of the University of Pondicherry for the educational excellence of his master’s degree. His studies have been published in high-impact peer-reviewed journals, adding PLOS Neglected Tropical Diseases and Systematic Biology. When he’s not running or writing, Hugo consumes copious amounts of anime and manga, composes and makes music on his bass, rides trails on his mountain bike, plays video games (he prefers the term “games”), or DIY. technological stuff.
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Francisco de Souza, Hugo. 2024. Paxlovid treatment in 20% of COVID-19 patients could avert 850,000 hospitalizations, save up to $170 billion. News-Medical, viewed 16 January 2024, https://www.news-medical.net/news/20240114/Paxlovid-treatment-in-2025-of-COVID-19-patients-could-avert-850000-hospitalizations-save-up-to-24170-billion.aspx.
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