The Clinically Validated Viral Superinfection Therapy (SIT) Platform Technology May Mitigate Severe Cases of 2019-nCoV Infections

Stochastic simulations of early outbreak trajectories found that the basic reproduction number, R0, of the Wuhan new coronavirus (2019-nCoV) is around 2.2, which indicates the potential for sustained human-to-human transmission. In fact, this transmission characteristic is a similar magnitude to severe acute respiratory syndrome-related coronavirus (SARS-CoV) and the 1918 pandemic influenza. Cases have now spread to at least 4 continents, currently with 43,108 cases and 1,018 lives lost. The World Health Organization (WHO) declared the outbreak a public health emergency of international concern. There is no current evidence from random clinical trials (RCTs) to recommend any specific anti-nCoV treatment for patients with suspected or confirmed 2019-nCoV infection. In order to mitigate the impact of the 2019-nCoV outbreak, here we propose an innovative superinfection therapeutic (SIT) strategy, which could complement the development of prophylactic vaccines. SIT is based on clinical observations that unrelated viruses might interact in co-infected patients. During SIT, the patient benefit from superinfection with an apathogenic dsRNA virus such as the infectious bursal disease virus (IBDV), which is a powerful activator of the interferon-dependent antiviral gene program. An attenuated vaccine strain of IBDV was already successfully administered to resolve acute and persistent infections induced by two completely different viruses, the hepatitis B (DNA) and C (RNA) viruses (HBV/HCV). Importantly, IBDV is also a potential prophylactic vaccine vector drug candidate, since a recombinant IBDV was previously generated that displays exogenous viral peptides from a replication-competent IBDV.