The interplay of viral loads, clinical presentation, and serological responses in SARS-CoV-2 - Results from a prospective cohort of outpatient COVID-19 cases

Virology. 2022 Apr:569:37-43. doi: 10.1016/j.virol.2022.02.002. Epub 2022 Feb 18.

Abstract

Risk factors for disease progression and severity of SARS-CoV-2 infections require an understanding of acute and long-term virological and immunological dynamics. Fifty-one RT-PCR positive COVID-19 outpatients were recruited between May and December 2020 in Munich, Germany, and followed up at multiple defined timepoints for up to one year. RT-PCR and viral culture were performed and seroresponses measured. Participants were classified applying the WHO clinical progression scale. Short symptom to test time (median 5.0 days; p = 0.0016) and high viral loads (VL; median maximum VL: 3∙108 copies/mL; p = 0.0015) were indicative for viral culture positivity. Participants with WHO grade 3 at baseline had significantly higher VLs compared to those with WHO 1 and 2 (p = 0.01). VLs dropped fast within 1 week of symptom onset. Maximum VLs were positively correlated with the magnitude of Ro-N-Ig seroresponse (p = 0.022). Our results describe the dynamics of VLs and antibodies to SARS-CoV-2 in mild to moderate cases that can support public health measures during the ongoing global pandemic.

Keywords: COVID-19; Immune response; Public health; RT-PCR; SARS-CoV-2; Serological testing; Viral culture.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • COVID-19 / complications
  • COVID-19 / diagnosis*
  • COVID-19 / virology*
  • Child
  • Cohort Studies
  • Host-Pathogen Interactions
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Outpatients
  • Pandemics
  • SARS-CoV-2 / physiology*
  • Serologic Tests / methods
  • Symptom Assessment
  • Viral Load*
  • Young Adult