Potency and timing of antiviral therapy as determinants of duration of SARS CoV-2 shedding and intensity of inflammatory response

Ashish Goyal; E. Fabian Cardozo-Ojeda; Joshua T Schiffer

Third, effective dosing soon after onset of symptoms is predicted to have an insignificant effect on viral load AUC. This phenomenon occurs because the amount of virus produced per hour at the early peak is far higher than the amount produced per day during the lower viral load second decay phase. This finding provides a cautionary message: if subsequent disease severity and development is imprinted during the high viral load, pre-symptomatic phase of infection, then early antiviral therapy could theoretically eliminate further shedding without altering clinical outcomes. Moreover, if extremely high viral load periods are responsible for most transmissions as suggested by the 5-day generation time of infection (29) , then early elimination of shedding may not lower transmissibility either. Overall this result highlights the urgent need for studies which identify early viral and immune correlates of severe disease and . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.