Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.

The nosocomial transmission of respiratory pathogens is an ongoing healthcare challenge, with consequences for the health of vulnerable individuals. Outbreaks in hospitals can require the closure of bays or entire wards, reducing hospital capacity and having a financial impact upon healthcare provid...

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Main Authors: Lauren Stewart, Stephanie Evans, Teresa Brevini, Fotios Sampaziotis, Christopher J R Illingworth
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-08-01
Series:PLoS Computational Biology
Online Access:https://doi.org/10.1371/journal.pcbi.1013361
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author Lauren Stewart
Stephanie Evans
Teresa Brevini
Fotios Sampaziotis
Christopher J R Illingworth
author_facet Lauren Stewart
Stephanie Evans
Teresa Brevini
Fotios Sampaziotis
Christopher J R Illingworth
author_sort Lauren Stewart
collection DOAJ
description The nosocomial transmission of respiratory pathogens is an ongoing healthcare challenge, with consequences for the health of vulnerable individuals. Outbreaks in hospitals can require the closure of bays or entire wards, reducing hospital capacity and having a financial impact upon healthcare providers. Here we evaluate a novel strategy of pre-exposure prophylaxis as a means to reduce the nosocomial transmission of SARS-CoV-2. We model the effect of ursodeoxycholic acid (UDCA) upon levels of angiotensin-converting enzyme 2 (ACE2) expression, SARS-CoV-2 viral entry, and ultimately the probability of an infection. We then implement this model within simulations describing the spread of SARS-CoV-2 infections within a hospital context, simulating an intervention in which UDCA is given to patients on a ward for 10 days following the detection of a case of SARS-CoV-2 on that ward. Under default model parameters we infer a potential 17% reduction in the nosocomial transmission of SARS-CoV-2 to patients, with increased importation of cases into the hospital increasing the effectiveness of the intervention, and of the order 1000-2000 patient treatment days per nosocomial patient infection prevented. Our study provides preliminary evidence of the value of pre-exposure prophylaxis with UDCA as a strategy to reduce nosocomial SARS-CoV-2 transmission.
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spelling doaj-art-de6a44cd8ca1449f833f5502ba4934f22025-08-26T05:30:55ZengPublic Library of Science (PLoS)PLoS Computational Biology1553-734X1553-73582025-08-01218e101336110.1371/journal.pcbi.1013361Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.Lauren StewartStephanie EvansTeresa BreviniFotios SampaziotisChristopher J R IllingworthThe nosocomial transmission of respiratory pathogens is an ongoing healthcare challenge, with consequences for the health of vulnerable individuals. Outbreaks in hospitals can require the closure of bays or entire wards, reducing hospital capacity and having a financial impact upon healthcare providers. Here we evaluate a novel strategy of pre-exposure prophylaxis as a means to reduce the nosocomial transmission of SARS-CoV-2. We model the effect of ursodeoxycholic acid (UDCA) upon levels of angiotensin-converting enzyme 2 (ACE2) expression, SARS-CoV-2 viral entry, and ultimately the probability of an infection. We then implement this model within simulations describing the spread of SARS-CoV-2 infections within a hospital context, simulating an intervention in which UDCA is given to patients on a ward for 10 days following the detection of a case of SARS-CoV-2 on that ward. Under default model parameters we infer a potential 17% reduction in the nosocomial transmission of SARS-CoV-2 to patients, with increased importation of cases into the hospital increasing the effectiveness of the intervention, and of the order 1000-2000 patient treatment days per nosocomial patient infection prevented. Our study provides preliminary evidence of the value of pre-exposure prophylaxis with UDCA as a strategy to reduce nosocomial SARS-CoV-2 transmission.https://doi.org/10.1371/journal.pcbi.1013361
spellingShingle Lauren Stewart
Stephanie Evans
Teresa Brevini
Fotios Sampaziotis
Christopher J R Illingworth
Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.
PLoS Computational Biology
title Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.
title_full Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.
title_fullStr Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.
title_full_unstemmed Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.
title_short Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.
title_sort modelling the potential use of pre exposure prophylaxis to reduce nosocomial sars cov 2 transmission
url https://doi.org/10.1371/journal.pcbi.1013361
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