Observational studyThe Lancet. Infectious diseases2020
Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study.
Observational study in The Lancet. Infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 11 registered trials, which are not on this map. Cited by 1,814 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Transmissibility and Viral Load of SARS-CoV-2 Through Oral Secretions
Randomized Placebo-controlled Trial of Hydroxychloroquine With or Without Azithromycin for Virologic Cure of COVID-19
Evaluation Of Efficacy Of COVID-19 Convalescent Plasma Versus Standard Plasma In The Early Care Of COVID-19 Patients Hospitalized Outside Intensive Care Units.
Effectiveness and Safety of Convalescent Plasma Therapy on COVID-19 Patients With Acute Respiratory Distress Syndrome in Referral Hospitals in Indonesia
Treatment of Critically Ill Patients With Covid-19 With Convalescent Plasma
Evaluation of a Screening Program for SARS-CoV-2 Infection in the General Population Based on the Use of New Detection Approaches or for Diagnostic Orientation on Saliva (COVID-19)
Novel Use of an Existing Vaccine (BCG) Alliance: The NUEVA Trial
A Randomized, Double-Blind, Comparative Trial of the Safety and Efficacy of Famotidine vs Placebo for the Treatment of Non-Hospitalized Symptomatic Adults With COVID-19
Assessing Testing Strategies for Safe Return to K-12 Schools in an Underserved Population
Prevention of Acute Respiratory Infection in Taiwanese Institutionalized Elderly (PARITIE)
A Pilot Clinical Evaluation of Astepro® Nasal Spray for Management of Early SARS-CoV-2 Infection
Who cites it
1,814 citing papers in PubMed, 2 syntheses or guidelines pooled it, 3,360 citations in OpenAlex.
- Emerging trends and hotspots in Oseltamivir resistance: insights from a bibliometric investigation.Naunyn-Schmiedeberg's archives of pharmacology · 2026Pooled it
- Pooled it
- Population pharmacokinetic/pharmacodynamic modelling to evaluate favipiravir in combination with lopinavir-ritonavir in patients with COVID-19.British journal of clinical pharmacology · 2026Trial
- Effect of 1% HInternational dental journal · 2024Trial
- Mouth rinses efficacy on salivary SARS-CoV-2 viral load: A randomized clinical trial.Journal of medical virology · 2023Trial
- Effect of oral antiseptics in reducing SARS-CoV-2 infectivity: evidence from a randomized double-blind clinical trial.Emerging microbes & infections · 2022Trial
- Plasma proteomics reveal SERPINA1 and CD59 as candidate biomarkers for COVID-19 severity stratification and prognosis prediction.Annals of medicine · 2026Article
- SARS-CoV-2 Exposure Elicits a Strong Mucosal Antibody Response That May Facilitate Quicker Mucosal Viral Clearance.Viruses · 2026Article
- Newborn IgG and IgM antibodies to maternal SARS-CoV-2 infection in pregnancy and child neurodevelopmental outcomes.Brain, behavior, and immunity · 2026Article
- Mathematical Modeling of Viral RNA Copies in Indoor Environments: Pre-Processor for Risk Assessment and Decision-Making Support Tool for Public Health.Risk analysis : an official publication of the Society for Risk Analysis · 2026Article
- Development and Validation of a Rapid Titer Assay for the Oncolytic Virus oHSV2 Expressing a PD-L1/CD3 Bispecific Antibody.Viruses · 2026Article
- The Risk from Reopening International Travel During a Disease X Pandemic: A Case Study of SARS-CoV-2.Risk analysis : an official publication of the Society for Risk Analysis · 2026Article
- Ordinary differential equation models of SARS-CoV-2 replication dynamics and antiviral drug efficacies.Npj viruses · 2026Review
- Estimating the incidence of SARS-CoV-2 infections by jointly modelling seroprevalence, hospitalization and mortality data, February 2020 - January 2021, Belgium.Archives of public health = Archives belges de sante publique · 2026Article
- Article
- Symptom burden, viral load, and antibody response to ancestral SARS-CoV-2 strain [D614G] in an outpatient household cohort.PloS one · 2026Article
- The Role of Microbiota Homeostasis in the Progression and Treatment of Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary disease · 2026Review
- Prioritizing Risk Factors for Nosocomial COVID-19 Infection in a Taiwanese Hospital: An Integrated DEMATEL-ANP-IPA Approach.Risk management and healthcare policy · 2026Article
- Article
- Age, sex and seasonal differences in COVID-19 viral load: a Lebanese cross-sectional study.BMC infectious diseases · 2025Article
1,754 more citing papers are in PubMed but not listed here.
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Authors and funding
25 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronavirus disease 2019 (COVID-19) causes severe community and nosocomial outbreaks. Comprehensive data for serial respiratory viral load and serum antibody responses from patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are not yet available. Nasopharyngeal and throat swabs are usually obtained for serial viral load monitoring of respiratory infections but gathering these specimens can cause discomfort for patients and put health-care workers at risk. We aimed to ascertain the serial respiratory viral load of SARS-CoV-2 in posterior oropharyngeal (deep throat) saliva samples from patients with COVID-19, and serum antibody responses.
methodsWe did a cohort study at two hospitals in Hong Kong. We included patients with laboratory-confirmed COVID-19. We obtained samples of blood, urine, posterior oropharyngeal saliva, and rectal swabs. Serial viral load was ascertained by reverse transcriptase quantitative PCR (RT-qPCR). Antibody levels against the SARS-CoV-2 internal nucleoprotein (NP) and surface spike protein receptor binding domain (RBD) were measured using EIA. Whole-genome sequencing was done to identify possible mutations arising during infection.
findingsBetween Jan 22, 2020, and Feb 12, 2020, 30 patients were screened for inclusion, of whom 23 were included (median age 62 years [range 37-75]). The median viral load in posterior oropharyngeal saliva or other respiratory specimens at presentation was 5·2 log
interpretationPosterior oropharyngeal saliva samples are a non-invasive specimen more acceptable to patients and health-care workers. Unlike severe acute respiratory syndrome, patients with COVID-19 had the highest viral load near presentation, which could account for the fast-spreading nature of this epidemic. This finding emphasises the importance of stringent infection control and early use of potent antiviral agents, alone or in combination, for high-risk individuals. Serological assay can complement RT-qPCR for diagnosis.
fundingRichard and Carol Yu, May Tam Mak Mei Yin, The Shaw Foundation Hong Kong, Michael Tong, Marina Lee, Government Consultancy Service, and Sanming Project of Medicine.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.