Stewart Lauren, Evans Stephanie, Brevini Teresa, Sampaziotis Fotios, Illingworth Christopher J R
MRC University of Glasgow Centre for Virus Research, Glasgow, United Kingdom.
Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, United Kingdom.
PLoS Comput Biol. 2025 Aug 5;21(8):e1013361. doi: 10.1371/journal.pcbi.1013361. eCollection 2025 Aug.
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.
呼吸道病原体的医院内传播是一个持续存在的医疗挑战，会对易感个体的健康产生影响。医院内的疫情爆发可能需要关闭病区或整个病房，从而降低医院的收治能力，并对医疗服务提供者造成经济影响。在此，我们评估一种新型的暴露前预防策略，作为减少严重急性呼吸综合征冠状病毒2（SARS-CoV-2）医院内传播的一种手段。我们模拟了熊去氧胆酸（UDCA）对血管紧张素转换酶2（ACE2）表达水平、SARS-CoV-2病毒进入以及最终感染概率的影响。然后，我们在描述SARS-CoV-2在医院环境中传播的模拟中应用该模型，模拟一种干预措施，即在某病房检测到一例SARS-CoV-2病例后，对该病房的患者给予UDCA治疗10天。在默认模型参数下，我们推断SARS-CoV-2向患者的医院内传播可能减少17%，随着医院内病例输入的增加，干预措施的有效性也会提高，每预防一例医院内患者感染可节省约1000-2000个患者治疗日。我们的研究为使用UDCA进行暴露前预防作为减少医院内SARS-CoV-2传播的策略的价值提供了初步证据。
