In silico evaluation of Paxlovid's pharmacometrics for SARS-CoV-2: a multiscale approach

Paxlovid is a promising, orally bioavailable novel drug for SARS–CoV–2 with excellent safety profiles. Our main goal here is to explore the pharmacometric features of this new antiviral. To provide a detailed assessment of Paxlovid, we propose a hybrid multiscale mathematical approach. We demonstrate that the results of the present $\mathit{\text{in}}\mathit{\text{silico}}$ evaluation match the clinical expectations remarkably well: on the one hand, our computations successfully replicate the outcome of an actual $\mathit{\text{in}}\mathit{\text{vitro}}$ experiment; on the other hand we verify both the sufficiency and the necessity of Paxlovid’s two main components (nirmatrelvir and ritonavir) for a simplified $\mathit{\text{in}}\mathit{\text{vivo}}$ case. Moreover, in the simulated context of our computational framework we visualize the importance of early interventions, and identify the time window where a unit–length delay causes the highest level of tissue damage. Finally, the results’ sensitivity to the diffusion coefficient of the virus is explored in details.