It is a global health priority to develop an effective antiviral drug for the treatment of COVID-19. Many drugs are being developed and studied, but the clinical trials do not show good evidence on how effective they are. Perelson and colleagues note most clinical trials have failed to observe a statistically significant effect. This could be due to poor designs of clinical trials. Thus, the authors of this paper decided to conduct an investigation on how clinical trials for antivirals need to be designed.In this work the scientists conducted a modeling study in an effort to understand the reasons why previous clinical trial findings have been inconsistent and to help design better trials. COVID-19 virus dynamics were quantified by fitting a virus dynamic model to longitudinal viral load data. The analysis of viral loads revealed three distinct groups characterized by different virus decay rates. This could be a confounding factor in past observational studies
Top image is a figure from the publication. Schematic illustration for the simulation mimicking randomized controlled trials for antiviral drugs.