Association of viral load with serum biomakers among COVID-19 cases

Abstract

Since SARS-CoV-2 spreads rapidly around the world, data have been needed on the natural fluctuation of viral load and clinical indicators associated with it. We measured and compared viral loads of SARS-CoV-2 from pharyngeal swab, IgM anti-SARS-CoV-2, CRP and SAA from serum of 114 COVID-19 patients on admission. Positive rates of IgM anti-SARS-CoV-2, CRP and SAA were 80.7%, 36% and 75.4% respectively. Among IgMpositive patients, viral loads showed different trends among cases with different severity, While viral loads of IgM-negative patients tended to increase along with the time after onset. As the worsening of severity, the positive rates of CRP and SAA also showed trends of increase. Different CRP/SAA type showed associations with viral loads in patients in different severity and different time after onset. Combination of the IgM and CRP/SAA with time after onset and severity may give suggestions on the viral load and condition judgment of COVID-19 patients. Dear Editor I'm sending a original article entitled "Association of Viral Load With Serum Biomakers Among COVID-19 Cases", which we would like to submit for publication in VIROLOGY. No part of this article has been published or submitted elsewhere, and no conflict of interest exists in the submission of this manuscript. In this article, we investigated the natural fluctuation of viral load among COVID-19 cases before antiviral therapy and the serum biomarkers associated with it. We found the viral loads had different trends and peaked at different time among COVID-19 patients. Combining the detection of IgM anti-SARS-CoV-2, C-reactive protein and Serum amyloid A may give suggestions on the viral load and condition judgment of COVID-19 patients at different stages of illness. The changes of viral load among patients of different clinical severity and different time after onset also can be tracked and used to inform public health policies to prevent the spread of SARS-CoV-2. The findings may facilitate the prevention and control of COVID-19.

Clinical utility of cycle threshold values in the context of COVID-19

“…The PRISMA owchart of included studies is shown in Figure 1. Data from 18 studies were relevant for inclusion and are summarised in Tables 1 and 2. Twelve studies (63%) were conducted in China or Hong Kong, [10][11][12][13][14][15][16][17][18][19][20][21] three studies were performed in Europe [22][23][24] and three studies were carried out in the USA or Canada. [25][26][27] Nearly all studies reported data for specimens from the respiratory tract, although two studies analysed saliva, 21,22 one used stool and serum samples in addition to respiratory samples, 19 and one used both throat and anal swabs.…”

“…Six studies analysed SARS-CoV-2 Ct values at multiple time points for each patient, 10,11,[18][19][20][21] and seven studies determined Ct values at hospital admission or diagnosis. [12][13][14][15][16][17]22 Fourteen studies reported on the direct correlation of outcomes with Ct values. [10][11][12][13][14]16,17,20,[22][23][24][25][26][27] Three studies reported on the correlation of outcomes with viral load, determined using standard curves of Ct values versus RNA copy number, 15,19,21 and one study correlated outcomes with the inverse of Ct values, taken as a proxy for viral load.…”

“…Eleven studies (with numbers of PCR-positive patients ranging from 10 to 308) reported on the correlation between Ct value and disease severity, [10][11][12][13][14]16,17,20,23,25,26 ower Ct values from respiratory samples were associated with more severe disease in 7 (64%) of these ( Table 2). [11][12][13][14]16,17,23 Three studies (with numbers of PCR-positive patients ranging from 23 to 114) reported on the correlation between viral load determined via Ct values and disease severity 15,19,21 and one of these (which included 96 patients) reported that higher viral loads were signi cantly associated with more severe disease ( Table 2). 19 Of the 15 studies reporting on the correlation between Ct value or viral load determined via Ct value and disease severity, 11 were performed in hospitalised patients [10][11][12][13][14][15][16][17]19,21,23 and three included non-hospitalised patients.…”

Establishment of a Pediatric COVID-19 Biorepository: Unique Considerations and Opportunities for Studying the Impact of the COVID-19 Pandemic on Children

“…Case reports and recent research studies suggests that asymptomatic children carry high viral loads despite lack of symptoms [4][5][6]. In adults, severe infection is not necessarily associated with a signi cant increase in viral loads by nasopharyngeal swab [7], and asymptomatic individuals appear to have equal viral loads as symptomatic individuals [8]. The potential correlations between viral load, symptoms, and exposures have yet to be clari ed in the pediatric population.…”

“…The potential correlations between viral load, symptoms, and exposures have yet to be clari ed in the pediatric population. Age-strati cation within adults show no differences in viral load across age-groups, although younger patients were less likely to develop severe disease [7], thus a similar comparison among children would be informative. Additional questions remain as to whether there are risk factors affecting viral load density in children, including household contacts or other environmental factors.…”