COVID-19肺炎和COVID-19相关肺曲霉病建模:敏感性分析和最优控制。

IF 3 3区 医学 Q2 INFECTIOUS DISEASES
Mallela Ankamma Rao, Emad K Jaradat, Medisetty Padma Devi, Prasantha Bharathi Dhandapani, Rebecca Muhumuza Nalule, Mohannad Al-Hmoud
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引用次数: 0

摘要

COVID-19重症病例可发展为肺炎,在一些患者中还可发展为与COVID-19相关的肺曲霉病(CAPA),这是一种与高死亡率相关的真菌合并感染。大多数现有模型仅处理COVID-19的传播,而没有明确捕获肺炎和CAPA的顺序进展。为了解决这一差距,我们开发了一种新的室室模型(SIIcpIcaHR),该模型整合了COVID-19肺炎和CAPA的共同动力学,包括疾病进展途径和住院过程。该模型使用来自印度的COVID-19累积病例数据进行校准,并通过稳定性理论、敏感性分析和最优控制框架进行分析。敏感性指数和部分秩相关系数确定了影响传播和严重程度的关键参数。我们使用庞特里亚金最大原理和数值模拟,单独和联合评估了时间依赖性干预策略——接种疫苗、早期住院和强化治疗。结果表明,虽然每一项措施都能减轻疾病负担,但所有三种措施的联合应用可显著减少肺炎和CAPA的患病率,降低住院需求,并且在现实限制下具有成本效益。这些发现强调了综合公共卫生战略的重要性,将药物和临床干预相结合,以遏制COVID-19的严重后果和相关的真菌并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modeling COVID-19 pneumonia and COVID-associated pulmonary aspergillosis: sensitivity analysis and optimal control.

Severe cases of COVID-19 can progress to pneumonia and, in some patients, to COVID-19-associated pulmonary aspergillosis (CAPA), a fungal co-infection linked to high mortality. Most existing models address COVID-19 transmission alone, without explicitly capturing the sequential progression to pneumonia and CAPA. To address this gap, we develop a novel compartmental model (SIIcpIcaHR) that integrates the co-dynamics of COVID-19 pneumonia and CAPA, incorporating both disease progression pathways and hospitalisation processes. The model is calibrated using cumulative COVID-19 case data from India, and analysed through stability theory, sensitivity analysis, and an optimal control framework. Sensitivity indices and Partial Rank Correlation Coefficients identify key parameters influencing transmission and severity. We evaluate time-dependent intervention strategies-vaccination, early hospitalisation, and enhanced treatment-individually and in combination, using Pontryagin's Maximum Principle and numerical simulation. Results show that while each single measure reduces disease burden, combined application of all three significantly minimises pneumonia and CAPA prevalence, lowers hospitalisation needs, and is cost-effective within realistic constraints. These findings emphasise the importance of integrated public health strategies that couple pharmaceutical and clinical interventions to curb severe COVID-19 outcomes and associated fungal complications.

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来源期刊
BMC Infectious Diseases
BMC Infectious Diseases 医学-传染病学
CiteScore
6.50
自引率
0.00%
发文量
860
审稿时长
3.3 months
期刊介绍: BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
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