Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching study

Background: Effective treatments for COVID-19 are needed to mitigate disease progression and reduce the burden on healthcare systems. This study investigates the impact of early treatments on SARS-CoV-2 viral shedding duration among high-risk individuals with mild symptoms. Methods: A single-center,...

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Main Authors: Marta Colaneri, Federico Fama, Federico Fassio, Darcy Holmes, Giovanni Scaglione, Chiara Mariani, Lucia Galli, Alessia Lai, Spinello Antinori, Andrea Gori, Agostino Riva, Monica Schiavini
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:International Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1201971224003369
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author Marta Colaneri
Federico Fama
Federico Fassio
Darcy Holmes
Giovanni Scaglione
Chiara Mariani
Lucia Galli
Alessia Lai
Spinello Antinori
Andrea Gori
Agostino Riva
Monica Schiavini
author_facet Marta Colaneri
Federico Fama
Federico Fassio
Darcy Holmes
Giovanni Scaglione
Chiara Mariani
Lucia Galli
Alessia Lai
Spinello Antinori
Andrea Gori
Agostino Riva
Monica Schiavini
author_sort Marta Colaneri
collection DOAJ
description Background: Effective treatments for COVID-19 are needed to mitigate disease progression and reduce the burden on healthcare systems. This study investigates the impact of early treatments on SARS-CoV-2 viral shedding duration among high-risk individuals with mild symptoms. Methods: A single-center, retrospective observational study was conducted at Luigi Sacco Hospital in Milan from December 2021 to March 2023. Hospitalized and nonhospitalized adults with a confirmed SARS-CoV-2 infection and at high-risk of disease progression were enrolled. Unadjusted and adjusted negative binomial regression models and a Random Forest regression model were performed before and after matching subjects based on their propensity of being treated or not. Results: Results from 518 subjects (428 treated and 90 untreated) revealed a significant reduction in SARS-CoV-2 viral shedding duration among those who received early treatment compared to untreated individuals. Propensity score matching and multivariable regression analyses confirmed this finding. Early treatment significantly reduced the risk of COVID-19-related hospitalization and pneumonia development. Subgroup analysis identified COPD as a potential factor influencing effectiveness of early treatments. Conclusions: Early treatments play a crucial role in reducing SARS-CoV-2 viral shedding and preventing disease progression among high-risk individuals. Shorter viral shedding duration also contributes to improved healthcare resource utilization and infection control measures.
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issn 1201-9712
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publishDate 2024-12-01
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series International Journal of Infectious Diseases
spelling doaj-art-6740203e726242589fb1d53b909529e82025-08-20T02:49:05ZengElsevierInternational Journal of Infectious Diseases1201-97122024-12-0114910726510.1016/j.ijid.2024.107265Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching studyMarta Colaneri0Federico Fama1Federico Fassio2Darcy Holmes3Giovanni Scaglione4Chiara Mariani5Lucia Galli6Alessia Lai7Spinello Antinori8Andrea Gori9Agostino Riva10Monica Schiavini11Department of Clinical Sciences, Infectious Diseases and Immunopathology, University of Milan, Luigi Sacco Hospital, Milan, Italy; Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, ItalyCorresponding author.; Department of Clinical Sciences, Infectious Diseases and Immunopathology, University of Milan, Luigi Sacco Hospital, Milan, Italy; Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, ItalyDepartment of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, ItalyInfectious Disease Unit Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Clinical Sciences, Infectious Diseases and Immunopathology, University of Milan, Luigi Sacco Hospital, Milan, ItalyDepartment of Clinical Sciences, Infectious Diseases and Immunopathology, University of Milan, Luigi Sacco Hospital, Milan, ItalyDepartment of Clinical Sciences, Infectious Diseases and Immunopathology, University of Milan, Luigi Sacco Hospital, Milan, ItalyDepartment of Biomedical and Clinical Sciences, University of Milan, Milan, ItalyDepartment of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, ItalyDepartment of Clinical Sciences, Infectious Diseases and Immunopathology, University of Milan, Luigi Sacco Hospital, Milan, Italy; Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, ItalyDepartment of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Infectious Diseases Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Clinical Sciences, Infectious Diseases and Immunopathology, University of Milan, Luigi Sacco Hospital, Milan, ItalyBackground: Effective treatments for COVID-19 are needed to mitigate disease progression and reduce the burden on healthcare systems. This study investigates the impact of early treatments on SARS-CoV-2 viral shedding duration among high-risk individuals with mild symptoms. Methods: A single-center, retrospective observational study was conducted at Luigi Sacco Hospital in Milan from December 2021 to March 2023. Hospitalized and nonhospitalized adults with a confirmed SARS-CoV-2 infection and at high-risk of disease progression were enrolled. Unadjusted and adjusted negative binomial regression models and a Random Forest regression model were performed before and after matching subjects based on their propensity of being treated or not. Results: Results from 518 subjects (428 treated and 90 untreated) revealed a significant reduction in SARS-CoV-2 viral shedding duration among those who received early treatment compared to untreated individuals. Propensity score matching and multivariable regression analyses confirmed this finding. Early treatment significantly reduced the risk of COVID-19-related hospitalization and pneumonia development. Subgroup analysis identified COPD as a potential factor influencing effectiveness of early treatments. Conclusions: Early treatments play a crucial role in reducing SARS-CoV-2 viral shedding and preventing disease progression among high-risk individuals. Shorter viral shedding duration also contributes to improved healthcare resource utilization and infection control measures.http://www.sciencedirect.com/science/article/pii/S1201971224003369COVID-19Time to negativizationViral sheddingEarly treatmentsHigh-risk subjectsCOPD
spellingShingle Marta Colaneri
Federico Fama
Federico Fassio
Darcy Holmes
Giovanni Scaglione
Chiara Mariani
Lucia Galli
Alessia Lai
Spinello Antinori
Andrea Gori
Agostino Riva
Monica Schiavini
Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching study
International Journal of Infectious Diseases
COVID-19
Time to negativization
Viral shedding
Early treatments
High-risk subjects
COPD
title Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching study
title_full Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching study
title_fullStr Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching study
title_full_unstemmed Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching study
title_short Impact of early antiviral therapy on SARS-CoV-2 clearance time in high-risk COVID-19 subjects: A propensity score matching study
title_sort impact of early antiviral therapy on sars cov 2 clearance time in high risk covid 19 subjects a propensity score matching study
topic COVID-19
Time to negativization
Viral shedding
Early treatments
High-risk subjects
COPD
url http://www.sciencedirect.com/science/article/pii/S1201971224003369
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