This CIDRAP post has two studies (not peer reviewed) which at first sight seem to add weight to the initial viral load hypothesis but do not seem to address the other confounding factors. In the first
"Wayne State University researchers in Detroit, involved a retrospective analysis of 708 initial nose-throat swabs from hospitalized coronavirus patients tested from Apr 4 to Jun 5 using reverse transcription polymerase chain reaction (RT-PCR). The goal was to better describe the effects of changing viral loads—which is a measure of virus density—at a population level."
I do not see that viral load at the point of hospital admission has anything to do with' viral density at a population level' it seems to have a great deal to do with at what point in disease progression the patient was tested. It then goes on to give loads at week 5 and 6 which is problematical given the retrospective analysis was performed over a 4 week period.
The second from Italy
"Researchers analyzed data from 373 COVID-19 patients in an emergency department in the northern city of Negrar to assess a possible association between the severity of coronavirus signs and symptoms with viral load as the pandemic transitioned from high to low transmission.
As patient viral loads declined over the course of the pandemic, the percentage of patients admitted to the ICU declined substantially from March (6.7%) to April (1.1%), and May (0.0%).
"As the epidemiological context changed from high to low transmission setting, people were presumably exposed to a lower viral load, which has been previously associated to less severe clinical manifestations," the authors wrote."
Again they are assuming initial viral load relates to later high viral titers but without allowing for the facts that there was lower threshold on hospitalisation as cases fell and that clinicians had more knowledge on patient care both of which I would expect to account for the change in ICU admission along with the changed age profile. To pick one factor and point to it seems unjustified. Also I have a big problem with the section in italics as I am unaware of any data that corroborates that statement.
"Wayne State University researchers in Detroit, involved a retrospective analysis of 708 initial nose-throat swabs from hospitalized coronavirus patients tested from Apr 4 to Jun 5 using reverse transcription polymerase chain reaction (RT-PCR). The goal was to better describe the effects of changing viral loads—which is a measure of virus density—at a population level."
I do not see that viral load at the point of hospital admission has anything to do with' viral density at a population level' it seems to have a great deal to do with at what point in disease progression the patient was tested. It then goes on to give loads at week 5 and 6 which is problematical given the retrospective analysis was performed over a 4 week period.
The second from Italy
"Researchers analyzed data from 373 COVID-19 patients in an emergency department in the northern city of Negrar to assess a possible association between the severity of coronavirus signs and symptoms with viral load as the pandemic transitioned from high to low transmission.
As patient viral loads declined over the course of the pandemic, the percentage of patients admitted to the ICU declined substantially from March (6.7%) to April (1.1%), and May (0.0%).
"As the epidemiological context changed from high to low transmission setting, people were presumably exposed to a lower viral load, which has been previously associated to less severe clinical manifestations," the authors wrote."
Again they are assuming initial viral load relates to later high viral titers but without allowing for the facts that there was lower threshold on hospitalisation as cases fell and that clinicians had more knowledge on patient care both of which I would expect to account for the change in ICU admission along with the changed age profile. To pick one factor and point to it seems unjustified. Also I have a big problem with the section in italics as I am unaware of any data that corroborates that statement.
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