Abstract
The relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) dose, infection, and coronavirus disease 2019 (COVID-19) outcomes remains poorly understood. This review summarizes the existing literature regarding this issue, identifies gaps in current knowledge, and suggests opportunities for future research. In humans, host characteristics, including age, sex, comorbidities, smoking, and pregnancy, are associated with severe COVID-19. Similarly, in animals, host factors are strong determinants of disease severity, although most animal infection models manifest clinically with mild to moderate respiratory disease. The influence of variants of concern as it relates to infectious dose, consequence of overall pathogenicity, and disease outcome in dose-response remains unknown. Epidemiologic data suggest a dose-response relationship for infection contrasting with limited and inconsistent surrogate-based evidence between dose and disease severity. Recommendations include the design of future infection studies in animal models to investigate inoculating dose on outcomes and the use of better proxies for dose in human epidemiology studies.
Keywords: COVID-19; SARS-CoV-2; disease severity; infectious dose; inoculum.
【저자키워드】 COVID-19, SARS-CoV-2, disease severity, infectious dose, inoculum., 【초록키워드】 coronavirus disease, Coronavirus disease 2019, coronavirus, severe COVID-19, Dose-response, Epidemiology, knowledge, disease severity, Infection, Comorbidities, variants of concern, Sex, animal model, animal models, outcome, smoking, severe acute respiratory syndrome Coronavirus, variants, Pregnancy, Characteristics, animals, humans, Respiratory disease, Research, Mild, age, pathogenicity, disease, moderate, Evidence, dose, infectious dose, mild to moderate, dose-response relationship, determinant, acute respiratory syndrome, Factor, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, future infection, inoculum, Host, identify, include, clinically, 【제목키워드】 review, coronavirus 2, respiratory,