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Modelling upper respiratory viral load dynamics of SARS-CoV-2.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Challenger, Joseph D  ORCID logo  https://orcid.org/0000-0001-6029-1733
Foo, Cher Y 
Wu, Yue 
Yan, Ada WC 
Marjaneh, Mahdi Moradi 

Abstract

Relationships between viral load, severity of illness, and transmissibility of virus are fundamental to understanding pathogenesis and devising better therapeutic and prevention strategies for COVID-19. Here we present within-host modelling of viral load dynamics observed in the upper respiratory tract (URT), drawing upon 2172 serial measurements from 605 subjects, collected from 17 different studies. We developed a mechanistic model to describe viral load dynamics and host response and contrast this with simpler mixed-effects regression analysis of peak viral load and its subsequent decline. We observed wide variation in URT viral load between individuals, over 5 orders of magnitude, at any given point in time since symptom onset. This variation was not explained by age, sex, or severity of illness, and these variables were not associated with the modelled early or late phases of immune-mediated control of viral load. We explored the application of the mechanistic model to identify measured immune responses associated with the control of the viral load. Neutralising antibodies correlated strongly with modelled immune-mediated control of viral load amongst subjects who produced neutralising antibodies. Our models can be used to identify host and viral factors which control URT viral load dynamics, informing future treatment and transmission blocking interventions.

Description

Keywords

Antibodies, Viral, COVID-19, Humans, SARS-CoV-2, Viral Load

Journal Title

BMC Med

Conference Name

Journal ISSN

1741-7015
1741-7015

Volume Title

20

Publisher

Springer Science and Business Media LLC
Sponsorship
imperial college london (Covid-19 Respond Fund)
Medical Research Council (MR/R015600/1, MR/V027409/1)
ukri (MR/V027409/1)