Timing of antiviral treatment initiation is critical to reduce SARS-Cov-2 viral load

Antonio Gonçalves; Julie Bertrand; Ruian Ke; Emmanuelle Comets; Xavier de Lamballerie; Denis Malvy; Andrés Pizzorno; Olivier Terrier; Manuel Rosa Calatrava; France Mentré; Patrick Smith; Alan S Perelson; Jérémie Guedj

We modeled the viral dynamics of 13 untreated patients infected with SARS-CoV-2 to infer 39 viral growth parameters and predict the effects of antiviral treatments. In order to reduce peak 40 viral load by more than 2 logs, drug efficacy needs to be greater than 80% if treatment is 41 administered after symptom onset; an efficacy of 50% could be sufficient if treatment is 42 initiated before symptom onset. Given their pharmacokinetic/pharmacodynamic properties, 43 current investigated drugs may be in a range of 20-70% efficacy. They may help control virus 44 if administered very early, but may not have a major effect in severe patients. 45 46 All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity. author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which 54 originated in Wuhan, China, has become a global pandemic. By March 29, 2020, this virus 55 had infected more than 700,000 people worldwide and caused more than 30,000 deaths. 56