ArticleMedical hypotheses2021
COVID-19: Does the infectious inoculum dose-response relationship contribute to understanding heterogeneity in disease severity and transmission dynamics?
Article in Medical hypotheses, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers.
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Who cites it
48 citing papers in PubMed.
- Explaining Racial and Ethnic Inequities in SARS-CoV-2-Related Outcomes: Results from a Serosurvey in Chicago.Journal of racial and ethnic health disparities · 2026Article
- From Trait-Structured Within-Host Dynamics to SIR Models: A Multiscale Framework With Re-Exposure.Bulletin of mathematical biology · 2026Article
- Article
- Barcoded SARS-CoV-2 viruses define the impact of duration and route of exposure on the transmission bottleneck in a hamster model.Science advances · 2025Article
- Symptom propagation in respiratory pathogens of public health concern: a review of the evidence.Journal of the Royal Society, Interface · 2024Review
- Evaluating the spike in the symptomatic proportion of SARS-CoV-2 in China in 2022 with variolation effects: a modeling analysis.Infectious Disease Modelling · 2024Article
- Epidemiological and health economic implications of symptom propagation in respiratory pathogens: A mathematical modelling investigation.PLoS computational biology · 2024Article
- Koch's curse: How models of extreme pathology bias studies of host-pathogen interactions.PLoS pathogens · 2024Article
- Long-term symptoms after SARS-CoV-2 infection in a cohort of hospital employees: duration and predictive factors.BMC infectious diseases · 2024Article
- A simplicial epidemic model for COVID-19 spread analysis.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Severity of respiratory tract infections depends on the infectious dose. Perspectives for the next pandemic.Frontiers in public health · 2024Article
- Propylene glycol inactivates respiratory viruses and prevents airborne transmission.EMBO molecular medicine · 2023Article
- Generative design for COVID-19 and future pathogens using stochastic multi-agent simulation.Sustainable cities and society · 2023Article
- Positive feedback loops exacerbate the influence of superspreaders in disease transmission.iScience · 2023Article
- XBB.1.5 Kraken cracked: Gibbs energies of binding and biosynthesis of the XBB.1.5 variant of SARS-CoV-2.Microbiological research · 2023Article
- Measured Air Flow Leakage in Facemask Usage.International journal of environmental research and public health · 2023Article
- Review
- Clinical and laboratory considerations: determining an antibody-based composite correlate of risk for reinfection with SARS-CoV-2 or severe COVID-19.Frontiers in public health · 2023Article
- Covid-19 vaccine effectiveness against general SARS-CoV-2 infection from the omicron variant: A retrospective cohort study.PLOS global public health · 2023Article
- Association between COVID-19 and consistent mask wearing during contact with others outside the household-A nested case-control analysis, November 2020-October 2021.Influenza and other respiratory viruses · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The variation in the speed and intensity of SARS-CoV-2 transmission and severity of the resulting COVID-19 disease are still imperfectly understood. We postulate a dose-response relationship in COVID-19, and that "the dose of virus in the initial inoculum" is an important missing link in understanding several incompletely explained observations in COVID-19 as a factor in transmission dynamics and severity of disease. We hypothesize that: (1) Viral dose in inoculum is related to severity of disease, (2) Severity of disease is related to transmission potential, and (3) In certain contexts, chains of severe cases can build up to severe local outbreaks, and large-scale intensive epidemics. Considerable evidence from other infectious diseases substantiates this hypothesis and recent evidence from COVID-19 points in the same direction. We suggest research avenues to validate the hypothesis. If proven, our hypothesis could strengthen the scientific basis for deciding priority containment measures in various contexts in particular the importance of avoiding super-spreading events and the benefits of mass masking.
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