RE: SARS-CoV-2 viral replication persists in the human lung for several weeks after onset of symptomatic9 Mar 2023 12:19
Definitely relevant.
It's why Shionogi is the first drug on STRIVE and why Paxlovid is the first drug on RECOVER
It was described as a hypothetical they wanted to explore in the STRIVE launch release from NIH - and this data will reassure them trial designers that they're on the right track
"Findings from the ACTIV-3 trials, which evaluated therapeutics for adults hospitalized with COVID-19, indicated that ongoing viral replication may play a role in driving disease progression to critical illness. The research team hypothesized that a significant number of patients hospitalized with COVID-19 may still benefit from antiviral therapy."
The first line of the STRIVE protocol repeats this
"Treatments are needed to improve outcomes among patients hospitalized for COVID-19, including direct-acting antiviral (DAA) agents to mitigate the pathology driven by ongoing viral replication. "
Viral clearance is the name of the game and the protease inhibitors - so far at least - are still working fine against Omicron I don't know what the viral clearance data is for SNG - perhaps someone else can reply with an answer if they know the data.
On Paxlo - Fruits - Americans are not being given it without a positive test - they just don't need to provide proof of it now - which is the same real world change they made in the Uk to make sure patients get the drug in the narrow window between symptoms and prescription. Highly unlikely that perfectly well individuals without Covid in the most drug suspicious country on earth might start asking for it just for the craic.
There's also little validity in the notion that NIH is trying to use up its stockpile. It has deleted approved therapeutics several times already with no consideration of the huge cost already invested in them.
You're keen to draw attention to the list of conflicting drug interactions - but make no mention of the fact that Paxlovid is specifically efficacious for immuno compromised patients - particularly those who cannot have vaccines. ( 90% reduction in hospitalisations and death in this group ) I trust the NHS to make certain there are no contra-indications before sending out the pills (having witnessed the process personally) - not so certain that MDs in the US are as scrupulous - but I'd imagine they are as observant of the hypocratic oath as our own docs.
The main point is that if SNG has good viral clearance data then it will be a candidate from both platforms, but chucking ill-informed mud at what is the last option for many people does not advance the SNG case one iota