SARS-CoV-2 viral load: Implication in COVID-19 pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity

The SARS-CoV-2 viral load may have importance in assessing COVID-19's pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity. The severity of the disease has been attributed to the dysregulated immune mechanisms, but studies have suggested a correlation between dis...

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Main Authors: Mayank Kapoor, Prasan Kumar Panda
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
Series:Journal of Medical Evidence
Subjects:
Online Access:http://www.journaljme.org/article.asp?issn=2667-0720;year=2021;volume=2;issue=3;spage=222;epage=227;aulast=Kapoor
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author Mayank Kapoor
Prasan Kumar Panda
author_facet Mayank Kapoor
Prasan Kumar Panda
author_sort Mayank Kapoor
collection DOAJ
description The SARS-CoV-2 viral load may have importance in assessing COVID-19's pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity. The severity of the disease has been attributed to the dysregulated immune mechanisms, but studies have suggested a correlation between disease severity and viral loads although evidence is not strong enough in justifying the same. Viraemia is shown to be keenly related to the disease progression. Viraemia has an association with increased Interleukin-6 levels and poorer prognosis. In terms of symptomatology, any definite correlations are not yet deduced, with no difference in viral loads among symptomatic and asymptomatic individuals. Reduction of viral load may be used as a marker of treatment success. Cycle threshold (Ct) values correlate with the SARS-CoV-2 viral loads. Ct values have shown a correlation with viral cultures and sub-genomic RNA values, both of which are considered the gold standard for determining infectivity but are expensive. Thereby, Ct value titres form an economical basis for deciding the de-isolation of the patients, which has implications in better resource management. Various limitations of viral load testing, especially of Ct values including human and laboratory factors are also discussed.
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spelling doaj.art-6e1f1809290e4206b6a6246110fd74a62022-12-22T03:03:14ZengWolters Kluwer Medknow PublicationsJournal of Medical Evidence2667-07202667-07392021-01-012322222710.4103/JME.JME_134_20SARS-CoV-2 viral load: Implication in COVID-19 pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivityMayank KapoorPrasan Kumar PandaThe SARS-CoV-2 viral load may have importance in assessing COVID-19's pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity. The severity of the disease has been attributed to the dysregulated immune mechanisms, but studies have suggested a correlation between disease severity and viral loads although evidence is not strong enough in justifying the same. Viraemia is shown to be keenly related to the disease progression. Viraemia has an association with increased Interleukin-6 levels and poorer prognosis. In terms of symptomatology, any definite correlations are not yet deduced, with no difference in viral loads among symptomatic and asymptomatic individuals. Reduction of viral load may be used as a marker of treatment success. Cycle threshold (Ct) values correlate with the SARS-CoV-2 viral loads. Ct values have shown a correlation with viral cultures and sub-genomic RNA values, both of which are considered the gold standard for determining infectivity but are expensive. Thereby, Ct value titres form an economical basis for deciding the de-isolation of the patients, which has implications in better resource management. Various limitations of viral load testing, especially of Ct values including human and laboratory factors are also discussed.http://www.journaljme.org/article.asp?issn=2667-0720;year=2021;volume=2;issue=3;spage=222;epage=227;aulast=Kapoorcoronaviruscycle thresholdcytokine stormnasopharyngeal swabviremia
spellingShingle Mayank Kapoor
Prasan Kumar Panda
SARS-CoV-2 viral load: Implication in COVID-19 pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity
Journal of Medical Evidence
coronavirus
cycle threshold
cytokine storm
nasopharyngeal swab
viremia
title SARS-CoV-2 viral load: Implication in COVID-19 pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity
title_full SARS-CoV-2 viral load: Implication in COVID-19 pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity
title_fullStr SARS-CoV-2 viral load: Implication in COVID-19 pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity
title_full_unstemmed SARS-CoV-2 viral load: Implication in COVID-19 pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity
title_short SARS-CoV-2 viral load: Implication in COVID-19 pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity
title_sort sars cov 2 viral load implication in covid 19 pathogenesis clinical presentation diagnosis treatment prognosis and infectivity
topic coronavirus
cycle threshold
cytokine storm
nasopharyngeal swab
viremia
url http://www.journaljme.org/article.asp?issn=2667-0720;year=2021;volume=2;issue=3;spage=222;epage=227;aulast=Kapoor
work_keys_str_mv AT mayankkapoor sarscov2viralloadimplicationincovid19pathogenesisclinicalpresentationdiagnosistreatmentprognosisandinfectivity
AT prasankumarpanda sarscov2viralloadimplicationincovid19pathogenesisclinicalpresentationdiagnosistreatmentprognosisandinfectivity