Leowattana W, Leowattana T, Leowattana P. SARS-CoV-2 viral load in the upper respiratory tract and disease severity in COVID-19 patients. World J Meta-Anal 2022; 10(4): 195-205 [DOI: 10.13105/wjma.v10.i4.195]
Corresponding Author of This Article
Wattana Leowattana, MD, MSc, PhD, Professor, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi road, Rachatawee, Bangkok 10400, Thailand. wattana.leo@mahidol.ac.th
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wattana Leowattana, Pathomthep Leowattana, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Tawithep Leowattana, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Thailand
Author contributions: Leowattana W wrote the paper; Leowattana T and Leowattana P collected the data.
Conflict-of-interest statement: All the author declares no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wattana Leowattana, MD, MSc, PhD, Professor, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi road, Rachatawee, Bangkok 10400, Thailand. wattana.leo@mahidol.ac.th
Received: April 1, 2022 Peer-review started: April 1, 2022 First decision: June 16, 2022 Revised: June 23, 2022 Accepted: July 27, 2022 Article in press: July 27, 2022 Published online: August 28, 2022
Abstract
Due to the disease's broad clinical spectrum, it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019 (COVID-19). Real-time reverse transcription-polymerase chain reaction (RT-PCR) is the gold standard molecular technique for diagnosing COVID-19. The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold (Ct) values. Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load. A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity. The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated. In this review, we describe the scientific data as well as the important findings from many clinical studies globally, emphasizing how viral load may be related to disease severity in COVID-19 patients. Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients, and early anti-viral treatment will reduce the severe clinical outcomes.
Core Tip: Real-time reverse transcription-polymerase chain reaction is regarded as the gold standard confirmatory test for coronavirus disease 2019 (COVID-19). Cycle threshold (Ct) values can be used to diagnose or forecast severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection since they are associated with virus load. Numerous differences exist in several clinical trials with small or large sample sizes, indicating a substantial positive correlation between the Ct value and disease severity in COVID-19. In this context, a literature review was conducted to address information gaps about the relationship between Ct levels and disease severity in COVID-19 patients globally. The majority of the data indicated a link between SARS-CoV-2 viral load and disease severity in these patients, and early anti-viral therapy will minimize the severity of the clinical outcomes.
