Highly-transmissible Variants of SARS-CoV-2 May Be More Susceptible to Drug Therapy Than Wild Type Strains

Highly-transmissible Variants of SARS-CoV-2 May Be More Susceptible to Drug Therapy Than Wild Type Strains | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Highly-transmissible Variants of SARS-CoV-2 May Be More Susceptible to Drug Therapy Than Wild Type Strains Verena Schöning, Charlotte Kern, Carlos Chaccour, Felix Hammann This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-379291/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract As of March 2021, no antiviral drug regimen has proved effective against SARS-CoV-2 infection. With the pandemic showing no signs of slowing down, and vaccine campaigns only starting to be rolled out, we appear to have few options other than non-pharmacological measures. Emerging Variants of Concern (VOCs), e.g. B1.1.7, B.1.351, and B.1.1.248, however, are characterized by higher transmissibility (R0). Here we model and simulate the effect of altered R0 on viral load profiles, and its impact on antiviral therapy. As a hypothetical case study, we simulated treatment with ivermectin 600µg/kg for 3 days initiated at different time points around the infection. Simulated mutations range from 1.25 to 2-fold greater infectivity, but also include putative co-adapted variants with lower transmissibility (0.75-fold). Antiviral efficacy was correlated with R0, making highly transmissible VOCs more sensitive to antiviral therapy. Viral exposure was reduced by 42% compared to 22% in wild type if treatment was started on inoculation. Less transmissible variants appear less susceptible. Our findings suggest there may be a role for pre- or post-exposure prophylactic antiviral treatment in areas with presence of highly transmissible variants. Furthermore, clinical trials with borderline efficacious results should consider identifying VOCs and examine their impact in post-hoc analysis. Clinical Pharmacology Toxicology COVID-19 mutations variant of concern antiviral repurposing Figures Figure 1 Figure 2 Full-Text Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF. Additional Declarations No competing interests reported. Supplementary Files 20210330Sars2variantssupplements.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-379291","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":20864767,"identity":"42f82c00-29c1-49da-9fcc-613dcc038ce7","order_by":0,"name":"Verena Schöning","email":"","orcid":"","institution":"University of Bern","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Verena","middleName":"","lastName":"Schöning","suffix":""},{"id":20864768,"identity":"008ae3e9-4e54-4531-b9a9-84ab6b5d5134","order_by":1,"name":"Charlotte Kern","email":"","orcid":"","institution":"University of Bern","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Charlotte","middleName":"","lastName":"Kern","suffix":""},{"id":20864769,"identity":"25d97d1b-5816-4d31-8584-7995a5aea736","order_by":2,"name":"Carlos Chaccour","email":"","orcid":"","institution":"ISGlobal, Hospital Clínic - Universitat de Barcelona","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Carlos","middleName":"","lastName":"Chaccour","suffix":""},{"id":20864770,"identity":"2975ca75-17a7-4670-bdc1-6f187dbedbd2","order_by":3,"name":"Felix Hammann","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9ElEQVRIiWNgGAWjYBAC+wPMDQcYGA5DuRUSQIK5gYGxAbcWA6AskpYzIC2MhLUwwLUwtjEQoYW9sfEwD8Nhed1ph589LpxnkSff3tjA8HMHHr/wHGw4OIPhv+G222nmxjO3SRQbnDnYwNh7Bo8tEokNBz4wHGbcdjvBTJp3m0TiBqAIM8SFOLTIP2w4kMBw2H7b7fRv0rxzJBLnz39IQIsEI9iWxG23c4C2NACtuMFIQAtPItAvBoeTgVrKpHmOAR12BijSi08L++HDn3kqDtsCHbZNmqemLnF+++GDD37i0QLViMY/QEjDKBgFo2AUjAL8AAAgrVrZWL7LRQAAAABJRU5ErkJggg==","orcid":"","institution":"University of Bern","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Felix","middleName":"","lastName":"Hammann","suffix":""}],"badges":[],"createdAt":"2021-03-31 10:29:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-379291/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-379291/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":8046812,"identity":"b97ffdfc-2c51-4909-b360-c4d43df61640","added_by":"auto","created_at":"2021-04-15 14:23:36","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":44199,"visible":true,"origin":"","legend":"Simulated viral load profiles by change in within-host infectivity (R0). 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