Higher viral loads in asymptomatic COVID-19 patients might be the invisible part of the iceberg
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ORIGINAL PAPER
Higher viral loads in asymptomatic COVID‑19 patients might be the invisible part of the iceberg Imran Hasanoglu1 · Gulay Korukluoglu2 · Dilek Asilturk1 · Yasemin Cosgun2 · Ayse Kaya Kalem1 · Ayşe Basak Altas2 · Bircan Kayaaslan1 · Fatma Eser1 · Esra Akkan Kuzucu2 · Rahmet Guner1 Received: 22 June 2020 / Accepted: 28 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose SARS-CoV-2 virus dynamics in different hosts and different samples and their relationship with disease severity have not been clearly revealed. The aim of this study is to evaluate the viral loads of 6 different sample types (nasopharyngeal/ oropharyngeal combined, oral cavity, saliva, rectal, urine, and blood) of patients with different ages and clinics, to reveal the relationship between disease course and SARS-CoV-2 viral load, and differences in viral loads of asymptomatic and symptomatic patients. Methods Nasopharyngeal/oropharyngeal, oral cavity, saliva, rectal, urine, and blood samples are collected from patients who were hospitalized with diagnosis of COVID-19 on admission. Laboratory analysis were carried out at Public Health Institute of Turkey Virology Reference and Research Laboratory. Results A total of 360 samples from 60 patients were obtained on admission. Fifteen (25%) of the patients were asymptomatic while 45 (75%) were symptomatic. A significant difference was found between mean ages of asymptomatic vs symptomatic patients (26.4 and 36.4, respectively, p = 0.0248). No PCR positivity were found in blood. Only one asymptomatic patient had positive PCR result for urine sample. Viral loads of asymptomatic patients were found to be significantly higher (p = 0.0141) when compared with symptomatic patients. Viral load had a significant negative trend with increasing age. A significant decrease in viral load was observed with increasing disease severity. Conclusion In conclusion, this study demonstrates that asymptomatic patients have higher SARSCoV-2 viral loads than symptomatic patients and unlike in the few study in the literature, a significant decrease in viral load of nasopharyngeal/ oropharyngeal samples was observed with increasing disease severity. Factors associated with poor prognosis are found to be significantly correlated with low viral load. Keywords COVID-19 · Viral load · Asymptomatic · Severity · Saliva · Urine · Anal swab · Oral cavity
* Imran Hasanoglu [email protected]
Fatma Eser [email protected]
Gulay Korukluoglu [email protected]
Esra Akkan Kuzucu [email protected]
Dilek Asilturk [email protected]
Rahmet Guner [email protected]
Yasemin Cosgun [email protected]
1
Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey
2
Virology Reference Laboratory, Public Health Institutions of Turkey, Ankara, Turkey
Ayse Kaya Kalem [email protected] Ayşe Basak Altas [email protected]
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