Abstract
Background: Since declaration of COVID-19 as a pandemic; researchers are trying to find out the clues for determining spread and transmission of the disease. Although viral load had been used for assessing severity, progress and transmissibility of the disease, yet, little is known about all factors associated with its changes. This study aims to explore the association of initial viral load among COVID-19 patients with sociodemographic characteristics and travel history.
 Subjects and Methods: Through a record based retrospective study, laboratory confirmed cases in the period from 7th March to 31st May 2020 were included in the study (n=381); The dependent variable was the recorded viral load measured in Ct count; while the dependent variables included socio-demographic characteristics of the patients and travel history. Data were analyzed using Statistical Package for Social sciences (SPSS) version 21. Student t test and ANOVA test were used and P value less <0.05 was considered as a level of significance.
 Results: Out of all respondents (n=381), there was dominance of male cases (74.0%) over females (26.0%). The great majority (83.5%) were primarily classified as being cases, while the rest were contacts (16.5%). Most of them were symptomatic (82.9%); mainly cough (44.4%), fever (41.2%), sore throat (22.0%) and runny nose (13.1%). Fifteen percent of the respondents reported that they had travelled abroad before coming back to the Kingdom of Saudi Arabia and discovered as positive for COVID-19.The mean vial load was higher in males (26.2±5.55), older cases (26.5±5.39), Saudis (26.4±5.58) and health care workers (26.9±6.32), nevertheless, these differences are not statistically significant p>0.05.There was no statistically significant difference in the viral load between symptomatic and asymptomatic cases (26.0±5.48 vs 26.6±5.63) p>0.5. Nevertheless, viral load was significantly lower among those who had fever (25.2±5.70) and dyspnea (26.4±5.46) and those who reported that they did not travel abroad (29.1±4.97) p<0.05.
 Conclusion and Recommendations: The current findings add more evidence to the assumption that it is likely that asymptomatic pre-symptomatic and symptomatic transmission is occurring and there is no difference between them in viral load whether they present as cases or contacts; therefore, the repeated assessment of viral load could be more valuable and informative for assessing progress of the COVID-19 on individual level rather than comparison between positive cases. Therefore, it is highly recommended to conduct further researches based on the changes of viral load along the course of the disease and find out the role of the demographic and clinical determinants on these changes.
Highlights
In December 2019 the outbreak of corona virus disease (COVID-19) began in China, to turn shortly into a pandemic affecting the whole world.The symptoms of the novel corona include fever, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting and diarrhea [1]
Fifteen percent of the respondents reported that they had travelled abroad before coming back to the Kingdom of Saudi Arabia and discovered as positive for COVID-19.The mean vial load was higher in males (26.2±5.55), older cases (26.5±5.39), Saudis (26.4±5.58) and health care workers (26.9±6.32), these differences are not statistically significant p>0.05.There was no statistically significant difference in the viral load between symptomatic and asymptomatic cases (26.0±5.48 vs 26.6±5.63) p>0.5
The current findings add more evidence to the assumption that it is likely that asymptomatic pre-symptomatic and symptomatic transmission is occurring and there is no difference between them in viral load whether they present as cases or contacts; the repeated assessment of viral load could be more valuable and informative for assessing progress of the COVID-19 on individual level rather than comparison between positive cases
Summary
In December 2019 the outbreak of corona virus disease (COVID-19) began in China, to turn shortly into a pandemic affecting the whole world.The symptoms of the novel corona include fever, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting and diarrhea [1]. Studying viral dynamics and their variation among population subgroups may help in understanding the role of epidemiological characteristics in the disease development and outcome. Uncertainty still exist regarding the relationship between viral load and severity, infectivity and duration of COVID-19’s viral dynamics and how they relate to factors in the population [4,5]. This study investigates the association of viral load with certain sociodemographic and the outcome of COVID-19 patients. Viral load had been used for assessing severity, progress and transmissibility of the disease, yet, little is known about all factors associated with its changes. This study aims to explore the association of initial viral load among COVID-19 patients with sociodemographic characteristics and travel history. Student t test and ANOVA test were used and P value less
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