Pharmaceutical and non-pharmaceutical interventions for controlling the COVID-19 pandemic.

Disease spread can be affected by pharmaceutical interventions (such as vaccination) and non-pharmaceutical interventions (such as physical distancing, mask-wearing and contact tracing). Understanding the relationship between disease dynamics and human behaviour is a significant factor to controlling infections. In this work, we propose a compartmental epidemiological model for studying how the infection dynamics of COVID-19 evolves for people with different levels of social distancing, natural immunity and vaccine-induced immunity. Our model recreates the transmission dynamics of COVID-19 in Ontario up to December 2021. Our results indicate that people change their behaviour based on the disease dynamics and mitigation measures. Specifically, they adopt more protective behaviour when mandated social distancing measures are in effect, typically concurrent with a high number of infections. They reduce protective behaviour when vaccination coverage is high or when mandated contact reduction measures are relaxed, typically concurrent with a reduction of infections. We demonstrate that waning of infection and vaccine-induced immunity are important for reproducing disease transmission in autumn 2021.

A mathematical model of protein subunits COVID-19 vaccines.

We consider a general mathematical model for protein subunit vaccine with a focus on the MF59-adjuvanted spike glycoprotein-clamp vaccine for SARS-CoV-2, and use the model to study immunological outcomes in the humoral and cell-mediated arms of the immune response from vaccination. The mathematical model is fit to vaccine clinical trial data. We elucidate the role of Interferon-γ and Interleukin-4 in stimulating the immune response of the host. Model results, and results from a sensitivity analysis, show that a balance between the TH1 and TH2 arms of the immune response is struck, with the TH1 response being dominant. The model predicts that two-doses of the vaccine at 28 days apart will result in approximately 85% humoral immunity loss relative to peak immunity approximately 6 months post dose 1.

Long-term durability of immune responses to the BNT162b2 and mRNA-1273 vaccines based on dosage, age and sex.

The lipid nanoparticle (LNP)-formulated mRNA vaccines BNT162b2 and mRNA-1273 are a widely adopted multi vaccination public health strategy to manage the COVID-19 pandemic. Clinical trial data has described the immunogenicity of the vaccine, albeit within a limited study time frame. Here, we use a within-host mathematical model for LNP-formulated mRNA vaccines, informed by available clinical trial data from 2020 to September 2021, to project a longer term understanding of immunity as a function of vaccine type, dosage amount, age, and sex. We estimate that two standard doses of either mRNA-1273 or BNT162b2, with dosage times separated by the company-mandated intervals, results in individuals losing more than 99% humoral immunity relative to peak immunity by 8 months following the second dose. We predict that within an 8 month period following dose two (corresponding to the original CDC time-frame for administration of a third dose), there exists a period of time longer than 1 month where an individual has lost more than 99% humoral immunity relative to peak immunity, regardless of which vaccine was administered. We further find that age has a strong influence in maintaining humoral immunity; by 8 months following dose two we predict that individuals aged 18-55 have a four-fold humoral advantage compared to aged 56-70 and 70+ individuals. We find that sex has little effect on the immune response and long-term IgG counts. Finally, we find that humoral immunity generated from two low doses of mRNA-1273 decays at a substantially slower rate relative to peak immunity gained compared to two standard doses of either mRNA-1273 or BNT162b2. Our predictions highlight the importance of the recommended third booster dose in order to maintain elevated levels of antibodies.

A machine learning approach to differentiate between COVID-19 and influenza infection using synthetic infection and immune response data.

Data analysis is widely used to generate new insights into human disease mechanisms and provide better treatment methods. In this work, we used the mechanistic models of viral infection to generate synthetic data of influenza and COVID-19 patients. We then developed and validated a supervised machine learning model that can distinguish between the two infections. Influenza and COVID-19 are contagious respiratory illnesses that are caused by different pathogenic viruses but appeared with similar initial presentations. While having the same primary signs COVID-19 can produce more severe symptoms, illnesses, and higher mortality. The predictive model performance was externally evaluated by the ROC AUC metric (area under the receiver operating characteristic curve) on 100 virtual patients from each cohort and was able to achieve at least AUC = 91% using our multiclass classifier. The current investigation highlighted the ability of machine learning models to accurately identify two different diseases based on major components of viral infection and immune response. The model predicted a dominant role for viral load and productively infected cells through the feature selection process.

Chemotherapy-induced cachexia and model-informed dosing to preserve lean mass in cancer treatment.

Although chemotherapy is a standard treatment for cancer, it comes with significant side effects. In particular, certain agents can induce severe muscle loss, known as cachexia, worsening patient quality of life and treatment outcomes. 5-fluorouracil, an anti-cancer agent used to treat several cancers, has been shown to cause muscle loss. Experimental data indicates a non-linear dose-dependence for muscle loss in mice treated with daily or week-day schedules. We present a mathematical model of chemotherapy-induced muscle wasting that captures this non-linear dose-dependence. Area-under-the-curve metrics are proposed to quantify the treatment's effects on lean mass and tumour control. Model simulations are used to explore alternate dosing schedules, aging effects, and morphine use in chemotherapy treatment with the aim of better protecting lean mass while actively targeting the tumour, ultimately leading to improved personalization of treatment planning and improved patient quality of life.

Analysis of Host Immunological Response of Adenovirus-Based COVID-19 Vaccines.

During the SARS-CoV-2 global pandemic, several vaccines, including mRNA and adenovirus vector approaches, have received emergency or full approval. However, supply chain logistics have hampered global vaccine delivery, which is impacting mass vaccination strategies. Recent studies have identified different strategies for vaccine dose administration so that supply constraints issues are diminished. These include increasing the time between consecutive doses in a two-dose vaccine regimen and reducing the dosage of the second dose. We consider both of these strategies in a mathematical modeling study of a non-replicating viral vector adenovirus vaccine in this work. We investigate the impact of different prime-boost strategies by quantifying their effects on immunological outcomes based on simple system of ordinary differential equations. The boost dose is administered either at a standard dose (SD) of 1000 or at a low dose (LD) of 500 or 250 vaccine particles. Results show dose-dependent immune response activity. Our model predictions show that by stretching the prime-boost interval to 18 or 20, in an SD/SD or SD/LD regimen, the minimum promoted antibody (Nab) response will be comparable with the neutralizing antibody level measured in COVID-19 recovered patients. Results also show that the minimum stimulated antibody in SD/SD regimen is identical with the high level observed in clinical trial data. We conclude that an SD/LD regimen may provide protective capacity, which will allow for conservation of vaccine doses.

Mathematical Model of Muscle Wasting in Cancer Cachexia.

Cancer cachexia is a debilitating condition characterized by an extreme loss of skeletal muscle mass, which negatively impacts patients' quality of life, reduces their ability to sustain anti-cancer therapies, and increases the risk of mortality. Recent discoveries have identified the myostatin/activin A/ActRIIB pathway as critical to muscle wasting by inducing satellite cell quiescence and increasing muscle-specific ubiquitin ligases responsible for atrophy. Remarkably, pharmacological blockade of the ActRIIB pathway has been shown to reverse muscle wasting and prolong the survival time of tumor-bearing animals. To explore the implications of this signaling pathway and potential therapeutic targets in cachexia, we construct a novel mathematical model of muscle tissue subjected to tumor-derived cachectic factors. The model formulation tracks the intercellular interactions between cancer cell, satellite cell, and muscle cell populations. The model is parameterized by fitting to colon-26 mouse model data, and the analysis provides insight into tissue growth in healthy, cancerous, and post-cachexia treatment conditions. Model predictions suggest that cachexia fundamentally alters muscle tissue health, as measured by the stem cell ratio, and this is only partially recovered by anti-cachexia treatment. Our mathematical findings suggest that after blocking the myostatin/activin A pathway, partial recovery of cancer-induced muscle loss requires the activation and proliferation of the satellite cell compartment with a functional differentiation program.

Environmental spatial and temporal variability and its role in non-favoured mutant dynamics.

Understanding how environmental variability (or randomness) affects evolution is of fundamental importance for biology. The presence of temporal or spatial variability significantly affects the competition dynamics in populations, and gives rise to some counterintuitive observations. In this paper, we consider both birth-death (BD) or death-birth (DB) Moran processes, which are set up on a circular or a complete graph. We investigate spatial and temporal variability affecting division and/or death parameters. Assuming that mutant and wild-type fitness parameters are drawn from an identical distribution, we study mutant fixation probability and timing. We demonstrate that temporal and spatial types of variability possess fundamentally different properties. Under temporal randomness, in a completely mixed system, minority mutants experience (i) higher than neutral fixation probability and a higher mean conditional fixation time, if the division rates are affected by randomness and (ii) lower fixation probability and lower mean conditional fixation time if the death rates are affected. Once spatial restrictions are imposed, however, these effects completely disappear, and mutants in a circular graph experience neutral dynamics, but only for the DB update rule in case (i) and for the BD rule in case (ii) above. In contrast to this, in the case of spatially variable environment, both for BD/DB processes, both for complete/circular graph and both for division/death rates affected, minority mutants experience a higher than neutral probability of fixation. Fixation time, however, is increased by randomness on a circle, while it decreases for complete graphs under random division rates. A basic difference between temporal and spatial kinds of variability is the types of correlations that occur in the system. Under temporal randomness, mutants are spatially correlated with each other (they simply have equal fitness values at a given moment of time; the same holds for wild-types). Under spatial randomness, there are subtler, temporal correlations among mutant and wild-type cells, which manifest themselves by cells of each type 'claiming' better spots for themselves. Applications of this theory include cancer generation and biofilm dynamics.

The effect of spatial randomness on the average fixation time of mutants.

The mean conditional fixation time of a mutant is an important measure of stochastic population dynamics, widely studied in ecology and evolution. Here, we investigate the effect of spatial randomness on the mean conditional fixation time of mutants in a constant population of cells, N. Specifically, we assume that fitness values of wild type cells and mutants at different locations come from given probability distributions and do not change in time. We study spatial arrangements of cells on regular graphs with different degrees, from the circle to the complete graph, and vary assumptions on the fitness probability distributions. Some examples include: identical probability distributions for wild types and mutants; cases when only one of the cell types has random fitness values while the other has deterministic fitness; and cases where the mutants are advantaged or disadvantaged. Using analytical calculations and stochastic numerical simulations, we find that randomness has a strong impact on fixation time. In the case of complete graphs, randomness accelerates mutant fixation for all population sizes, and in the case of circular graphs, randomness delays mutant fixation for N larger than a threshold value (for small values of N, different behaviors are observed depending on the fitness distribution functions). These results emphasize fundamental differences in population dynamics under different assumptions on cell connectedness. They are explained by the existence of randomly occurring "dead zones" that can significantly delay fixation on networks with low connectivity; and by the existence of randomly occurring "lucky zones" that can facilitate fixation on networks of high connectivity. Results for death-birth and birth-death formulations of the Moran process, as well as for the (haploid) Wright Fisher model are presented.