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


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)