The more viruses, the more organ damage: a quick test shows how to anticipate the worst cases of COVID-19

Among the greatest unknowns of COVID-19 is why the disease is so lethal for some people and so mild for others. We still don't know much of the reasons for its severity.

Although various hypotheses have been proposed to explain this fact, a team from the Department of Clinical Microbiology at Nanchang University in China has shown that there is a clear relationship between damage to organs and the amount of virus in the body. This may seem obvious, but it is not. Viral load is not always related to the damage it causes, especially in coronaviruses. In fact, this was warned by the WHO at the beginning of the pandemic. This team has shown that this viral load can be measured from a sample obtained with a smear on the throat, much faster and easier than one from blood, tissue or serum. This fact opens new doors to treatment and, above all, to diagnosis and early prevention.

The higher the viral load, the more organ damage

Unfortunately, some of the worst predictions about COVID-19 seem to be true in light of the most recent studies: the higher the viral load, the worse the prognosis patients have, even if they show mild symptoms early in the disease. This was confirmed by the latest study by the Department of Clinical Microbiology at Nanchang University in China.

In it, the researchers have observed that the greater the amount of virus, the greater the damage to the organs and the lower the white blood cell count, which is a measure related to the "health" of our immune system. In other words, the more viruses there are in our bodies, the consequences are more serious and severe.

Other studies, such as this one presented in Science in mid-March, confirmed that the higher the viral load, the greater the probability of infection, something that also seems obvious but that does not have to be the case. Both damage and virus transmission depend on many complex factors, not just the amount of virus available in the body. Among them are the infective capacity of the virus itself, which could be very low regardless of the amount, the defensive capacity of the person or other external agents.

Something similar occurs with damage to internal organs, which does not have to be directly related to the amount of virus but rather to how it acts on the cell, its speed, its ability to reproduce and which cells it preferentially attacks, among many others. stuff. This study, however, confirms that there is indeed this direct relationship of more viruses, more damage. And that is important in developing a preventive treatment strategy.

A strategy for before the worst happens

What is most interesting about the study is that the viral load to which the researchers refer was obtained from patients of all kinds: with mild, severe or asymptomatic symptoms, and from a throat mucus sample collected with a sterile swab. This test is quick, easy and fast. It is also useful to determine the viral load, as they have verified, and to link its result to the patient's prognosis.

Thus, even those who did not have symptoms, but showed a high viral load, quickly fell into serious condition and required hospital treatment. With this test, the researchers say, the worst can be prevented before it happens: the sample is taken and if the viral load falls within the "high" range, the most efficient strategy and monitoring for the patient can be decided.

With these data, which can be easily obtained, medical professionals will be able to decide more easily what to do in positive cases of COVID-19. For example, currently cases that test positive but have mild symptoms are often returned home and are asked to remain isolated.

A quick and simple test, based on the throat sample, would help to choose another strategy, isolating the patient in a hospital unit waiting for a serious worsening of his symptoms, with which he would begin to be treated preventively, minimizing damages and deaths from COVID-19.

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