|
|
|
| Overview of SARS-CoV-2 viral load and its clinical value |
| CHEN Ai-ping1,4, LI Tian-ping2, LING Hua3,4, ZHANG Yong-jun1,4 |
1. Chongqing Medical and Pharmaceutical College, Chongqing 401331,China;
2. Chongqing Municipal Key Laboratory for High Pathogemic Microbes, Chongqing 400042,China;
3. Chongqing Health Center for Women and Children, Chongqing 400013,China;
4. Chongqing Center for Disease Control and Prevention, Chongqing 400042,China |
|
|
|
|
Abstract During the unprecedented COVID-19 pandemic, detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral nucleic acids in diverse specimens from patients, people with suspected infection and their close contacts has been widely implemented in infection confirmation, patient management and transmission prevention. Viral nucleic acid detection results not only reflect the infection status in suspected cases, but also are used to quantify positive specimens in most assays. For most viral diseases, viral loads are theoretically associated with potent infectivity and prognostic outcomes in patients. In this review, the principles and characteristics of SARS-CoV-2 viral load detected by real time reverse transcription PCR (RT-PCR) and digital PCR are summarized. The distribution and dynamic changes in viral load in humans are discussed, and the correlations of viral load with disease severity, infectivity and prognostic indicators are analyzed. The comprehensive descriptions of COVID-19 characterization will help guide current practices in infection control, patient treatment and management, and combating the ongoing COVID-19 pandemic.
|
|
Received: 05 February 2021
|
|
|
|
Corresponding Authors:
Zhang Yong-jun, Email: yjzhang01@yahoo.com
|
|
|
|
[1] Mattioli IA, Hassan A, Oliveira ON Jr, Crespilho FN.On the challenges for the diagnosis of SARS-CoV-2 based on a review of current methodologies[J]. ACS Sens, 2020,5(12):3655-3677. DOI: 10.1021/acssensors.0c01382
[2] Afzal A.Molecular diagnostic technologies for COVID-19: Limitations and challenges[J]. J Adv Res, 2020,26:149-159. DOI: 10.1016/j.jare.2020.08.002
[3] Xu M, Wang D, Wang H, et al.COVID-19 diagnostic testing: technology perspective[J]. Clin Transl Med,2020,10(4):e158. DOI: 10.1002/ctm2.158
[4] Bennett JE, Dolin R, Blaser MJ.Mandell, douglas, and bennett’s principles and practice of infectious diseases, 9th edition[M]. Elsevier: Philadelphia, PA. 2020.
[5] Zhu N, Zhang D, Wang W, et al.A novel coronavirus from patients with pneumonia in China, 2019[J]. N Engl J Med,2020,382(8):727-733. DOI: 10.1056/NEJMoa2001017
[6] A R, Wang H, Wang W, Tan W. Summary of the Detection Kits for SARS-CoV-2 Approved by the National Medical Products Administration of China and Their Application for Diagnosis of COVID-19[J]. Virol Sin,2020,22:1-14. DOI: 10.1007/s12250-020-00331-1
[7] Duong K, Ou J, Li Z, et al.Increased sensitivity using real-time dPCR for detection of SARS-CoV-2[J]. Biotechniques,2021,70(1):7-20. DOI: 10.2144/btn-2020-0133
[8] Suo T, Liu X, Feng J, et al.ddPCR: a more accurate tool for SARS-CoV-2 detection in low viral load specimens[J]. Emerg Microbes Infect, 2020,9(1):1259-1268. DOI: 10.1080/22221751.2020.1772678
[9] Wang W, Xu Y, Gao R, et al.Detection of SARS-CoV-2 in Different Types of Clinical Specimens[J]. JAMA, 2020,323(18):1843-1844. DOI: 10.1001/jama.2020.3786
[10] Fajnzylber J, Regan J, Coxen K, et al.SARS-CoV-2 viral load is associated with increased disease severity and mortality[J]. Nat Commun, 2020,11(1):5493. DOI: 10.1038/s41467-020-19057-5
[11] Zheng S, Fan J, Yu F, et al.Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study[J]. BMJ, 2020,369:m1443. DOI: 10.1136/bmj.m1443
[12] Jang S, Rhee JY, Wi YM, Jung BK.Viral kinetics of SARS-CoV-2 over the preclinical, clinical, and postclinical period[J]. Int J Infect Dis, 2021,102:561-565. DOI: 10.1016/j.ijid.2020.10.099
[13] Tirupathi R, Ramparas TR, Wadhwa G, et al.Viral dynamics in the Upper Respiratory Tract (URT) of SARS-CoV-2[J]. Infez Med, 2020;28(4):486-499.
[14] Sun J, Tang X, Bai R, et al. The kinetics of viral load and antibodies to SARS-CoV-2[J]. Clin Microbiol Infect, 2020,26(12):1690.e1-1690.e4. DOI: 10.1016/j.cmi.2020.08.043
[15] Chen L, Wang G, Long X, et al.Dynamics of blood viral load is strongly associated with clinical outcomes in Coronavirus Disease 2019 (COVID-19) patients: a prospective cohort study[J]. J Mol Diagn, 2021;23(1):10-18. DOI: 10.1016/j.jmoldx.2020.10.007
[16] Silva J, Lucas C, Sundaram M, et al. Saliva viral load is a dynamic unifying correlate of COVID-19 severity and mortality[J]. medRxiv [Preprint], 2021,10:2021.01.04.21249236. DOI: 10.1101/2021.01.04.21249236
[17] Bullard J, Dust K, Funk D, et al.Predicting infectious SARS-CoV-2 from diagnostic samples[J]. Clin Infect Dis, 2020,71(10):2663-2666. DOI:10.1093/cid/ciaa638
[18] Singanayagam A, Patel M, Charlett A, et al.Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020[J]. Euro Surveill, 2020,25(32):2001483. DOI: 10.2807/1560-7917.ES.2020.25.32.2001483
[19] La Scola B, Le Bideau M, Andreani J, et al.Viral RNA load as determined by cell culture as a management tool for discharge of SARS-CoV-2 patients from infectious disease wards[J]. Eur J Clin Microbiol Infect Dis, 2020, 39(6):1059-1061. DOI: 10.1007/s10096-020-03913-9
[20] Choudhuri J, Carter J, Nelson R, et al.SARS-CoV-2 PCR cycle threshold at hospital admission associated with patient mortality[J]. PLoS One, 2020, 15(12): e0244777. DOI:10.1371/journal.pone.0244777
[21] Bryan A, Fink SL, Gattuso MA, et al. SARS-CoV-2 Viral Load on Admission Is Associated With 30-Day Mortality[J]. Open Forum Infect Dis, 2020,7(12):ofaa535. DOI: 10.1093/ofid/ofaa535
[22] Faíco-Filho KS, Passarelli VC, Bellei N.Is Higher Viral Load in SARS-CoV-2 Associated with Death[J]. Am J Trop Med Hyg, 2020,103(5):2019-2021. DOI: 10.4269/ajtmh.20-0954
[23] Prebensen C, Myhre PL, Jonassen C, et al. SARS-CoV-2 RNA in plasma is associated with ICU admission and mortality in patients hospitalized with COVID-19[J]. Clin Infect Dis,2020,5:ciaa1338. DOI: 10.1093/cid/ciaa1338
[24] Veyer D, Kernéis S, Poulet G, et al. Highly sensitive quantification of plasma SARS-CoV-2 RNA shelds light on its potential clinical value[J]. Clin Infect Dis,2020,17:ciaa1196. DOI: 10.1093/cid/ciaa1196 |
|
|
|
2021, Vol. 37 
