Unfortunately very few - any? - studies that I’ve seen relating viral load to outcome stratify by day post infection or symptom onset. This is big issue (viral load varies by day and people vary in when they get tested in disease course for many reasons). nytimes.com/live/2020/12/2…
For example, here’s data from my lab showing viral load by day for outpatients (purple) vs hospitalized patients (green). All tests were on presentation. If you just look at viral load on presentation, outpatients were higher - they were just tested earlier.
H/t to @Kalee_Rumfelt in my lab who did the chart review. Most studies don’t have day post symptom onset because it’s hard to retrieve. You typically don’t get it in data pulls from EMR. You have to go into chart notes one by one.
Been thinking more about this piece from @kakape this morning and have some thoughts to share. So thought I'd do a Xmas eve thread about SARS-CoV-2/COVID19 and immunocompromised hosts. (1/x) sciencemag.org/news/2020/12/u…
I emphasize that I respect the stated opinions out there and don't have doubts about data or what they may show. Just feel there's a perspective missing from the conversation. What can I bring to conversation? I am an infectious disease physician and study virus evolution. (2/x)
I have taken care of patients with COVID19 who have a range of immunocompromising conditions. I have also published on within host evolutionary dynamics of viruses. We published a preprint in Sept and subsequent JID paper on long term evolution in lymphoma patient. (3/x)
With the news of this new variant and discussions of what it means for vaccines, keep thinking about this article from @SCOTTeHENSLEY and Yewdell (who very much needs a Twitter account). Short thread.
First question from ID docs and many virologists I know is “OMG, what does this mean for vaccines.” We grow up in this pathogen vs. immune system paradigm that is sometimes distracting from issues at play. (2)
Many variants have been reported to escape this serum or that monoclonal. But large scale selection of a variant at this point is probably not driven by immune system (just not that much immunity around). (3)