Evidence map›Paper›PMID 41642857›Full record

ArticlePloS one2026

Symptom burden, viral load, and antibody response to ancestral SARS-CoV-2 strain [D614G] in an outpatient household cohort.

Mehal Churiwal, Kathleen Tompkins, Gabrielle Streeter, Christy Litel, Sydney Mason, Kelly Lin, Meredith Muller, Srijana Chhetri, Tia Belvin, Feng-Chang Lin and 6 more

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Mehal ChuriwalInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Kathleen TompkinsInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Gabrielle StreeterInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Christy LitelInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Sydney MasonInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Kelly LinInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.ORCID https://orcid.org/0009-0004-1497-476X
Meredith MullerInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Srijana ChhetriInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Tia BelvinInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Feng-Chang LinGillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America.
Christopher BashamInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Maureen WhittelseyInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Tyler RappInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.ORCID https://orcid.org/0000-0001-7166-1015
Lakshmanane PremkumarDepartment of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.
Carla CeramiMedical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, Gambia.
Jessica T LinInstitute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America.ORCID https://orcid.org/0000-0002-4516-723X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly in the SARS-CoV-2 pandemic, description of COVID-19 illness among non-hospitalized patients was limited. Data from household cohorts can help reveal the full spectrum of disease and the potential for long-term sequelae, even in non-severe disease.

methodsDaily symptom diaries were collected in a US household cohort of SARS-CoV-2 infection from April to November 2020, during the pre-COVID vaccine period. SARS-CoV-2 nasal viral loads were measured at study entry and weekly until day 21; serologic testing was performed at study entry and day 28. A subset of volunteers underwent an additional assessment 8-10 months later. Participants who met the criteria for early infection-testing antibody-negative at study entry but PCR-positive either at baseline or during follow-up-were included in this analysis (n = 143).

resultsDaily symptoms were ascertained in 143 outpatients with acute COVID-19, including 60 index cases who sought testing and 83 of their household contacts. Asymptomatic cases comprised 16% (13/83) of SARS-CoV-2 infections detected among household contacts. Among 119 persons with mild or moderate illness, the number of symptoms peaked 3 or 4 days after symptom onset. Fever and anosmia occurred in nearly half of participants. Symptom severity was associated with increased age, viral load, and cardiovascular disease. Increased BMI was associated with a higher antibody level at day 28, independent of symptom severity. Those with a higher day 28 antibody level were more likely to develop symptoms consistent with post-acute sequelae of SARS-CoV-2 (PASC), also known as long COVID-19, 8-10 months later.

conclusionsFever, anosmia, as well as asymptomatic infection were common features of COVID-19 non-severe illness when the D614G variant circulated in the US, before the availability of vaccines or outpatient therapies. Antibody levels following acute infection were linked to the development of symptoms of PASC 8-10 months later.

Indexed as

Antibodies, ViralCOVID-19SARS-CoV-2Viral LoadAdultAgedAntibody FormationCohort StudiesFamily CharacteristicsFemaleHumansMaleMiddle AgedOutpatientsPost-Acute COVID-19 SyndromeSymptom BurdenAntibodies, Viral

Identifiers

PMID41642857
PMCPMC12875513

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Registered trials

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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.