January 25th, 2021

A new report in Science Magazine shows us that our saliva holds some clues to SARS2 hospitalization risk and death. The higher the viral load in the saliva which represents deeper lung disease, the worse the outcome will be according to new research. This is in line with earlier studies showing us that when the viral volume increases and the immune system is unable to control the viral replication, the next event to occur will be the cytokine elevation and systemic inflammation that is the hallmark of severe COVID disease. Testing the viral load in the saliva early in the course of disease may add a layer of predictability for disease modification through medicine.

On another front, twin studies offer a rare glimpse at identical genes with disparate outcomes pointing a light at the epigenome and environmental influences or viral load at the disease outset. In this analysis of 35 year old identical twins admitted for COVID19 disease we find that the second person infected had the harder course despite having less co morbid disease pre infection. This is likely another sign that viral load is critical as the second twin was living with her work infected sister for a period of time before anyone was aware of the illness. (Goel et. al. 2021)

The bottom line here is that prolonged exposure to a mildly symptomatic or asymptomatic person will raise your viral load and worsen your prognosis. Close living environments always hamper the second to get infected as in this twin case.

Dr. M

Service Science Magazine
Goel J of Medical Cases