Association between SARS‐CoV‐2 viral kinetics and clinical score evolution in hospitalized patients Article Swipe
Nadège Néant
,
Guillaume Lingas
,
Alexandre Gaymard
,
Drifa Belhadi
,
Maya Hites
,
Thérèse Staub
,
Richard Greil
,
José Artur Paiva
,
Julien Poissy
,
Nathan Peiffer‐Smadja
,
Dominique Costagliola
,
Yazdan Yazdanpanah
,
Maude Bouscambert‐Duchamp
,
Amandine Gagneux‐Brunon
,
Florence Ader
,
France Mentré
,
Florent Wallet
,
Charles Burdet
,
Jérémie Guedj
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1002/psp4.13051
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1002/psp4.13051
The 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.
Related Topics
Concepts
Viral load
Medicine
Coronavirus disease 2019 (COVID-19)
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Internal medicine
Clinical trial
Antiviral treatment
Early warning score
Disease
Virus
Immunology
Emergency medicine
Infectious disease (medical specialty)
Chronic hepatitis
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/psp4.13051
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/psp4.13051
- OA Status
- gold
- Cited By
- 5
- References
- 22
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4386877617
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4386877617Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1002/psp4.13051Digital Object Identifier
- Title
-
Association between SARS‐CoV‐2 viral kinetics and clinical score evolution in hospitalized patientsWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-09-20Full publication date if available
- Authors
-
Nadège Néant, Guillaume Lingas, Alexandre Gaymard, Drifa Belhadi, Maya Hites, Thérèse Staub, Richard Greil, José Artur Paiva, Julien Poissy, Nathan Peiffer‐Smadja, Dominique Costagliola, Yazdan Yazdanpanah, Maude Bouscambert‐Duchamp, Amandine Gagneux‐Brunon, Florence Ader, France Mentré, Florent Wallet, Charles Burdet, Jérémie GuedjList of authors in order
- Landing page
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https://doi.org/10.1002/psp4.13051Publisher landing page
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-
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/psp4.13051Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/psp4.13051Direct OA link when available
- Concepts
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Viral load, Medicine, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Internal medicine, Clinical trial, Antiviral treatment, Early warning score, Disease, Virus, Immunology, Emergency medicine, Infectious disease (medical specialty), Chronic hepatitisTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
5Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 3, 2023: 1Per-year citation counts (last 5 years)
- References (count)
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22Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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