{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:19:43Z","timestamp":1790623183048,"version":"4.1.0"},"reference-count":91,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"unspecified","delay-in-days":103,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is pandemic. Prevention and control strategies require an improved understanding of SARS-CoV-2 dynamics. We did a rapid review of the literature on SARS-CoV-2 viral dynamics with a focus on infective dose. We sought comparisons of SARS-CoV-2 with other respiratory viruses including SARS-CoV-1 and Middle East respiratory syndrome coronavirus. We examined laboratory animal and human studies. The literature on infective dose, transmission and routes of exposure was limited specially in humans, and varying endpoints were used for measurement of infection. Despite variability in animal studies, there was some evidence that increased dose at exposure correlated with higher viral load clinically, and severe symptoms. Higher viral load measures did not reflect coronavirus disease 2019 severity. Aerosol transmission seemed to raise the risk of more severe respiratory complications in animals. An accurate quantitative estimate of the infective dose of SARS-CoV-2 in humans is not currently feasible and needs further research. Our review suggests that it is small, perhaps about 100 particles. Further work is also required on the relationship between routes of transmission, infective dose, co-infection and outcomes.<\/jats:p>","DOI":"10.1017\/s0950268821000790","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T01:05:47Z","timestamp":1618362347000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":112,"title":["Review of infective dose, routes of transmission and outcome of COVID-19 caused by the SARS-COV-2: comparison with other respiratory viruses"],"prefix":"10.1017","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9981-4404","authenticated-orcid":false,"given":"Sedighe","family":"Karimzadeh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Bhopal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9543-9440","authenticated-orcid":false,"given":"Huy","family":"Nguyen Tien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,4,14]]},"reference":[{"key":"S0950268821000790_ref46","doi-asserted-by":"publisher","DOI":"10.3201\/eid1211.060426"},{"key":"S0950268821000790_ref9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03530280047035"},{"key":"S0950268821000790_ref60","doi-asserted-by":"publisher","DOI":"10.1126\/science.abb7015"},{"key":"S0950268821000790_ref12","doi-asserted-by":"publisher","DOI":"10.1128\/BR.30.3.517-529.1966"},{"key":"S0950268821000790_ref51","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3227"},{"key":"S0950268821000790_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(20)30089-6"},{"key":"S0950268821000790_ref52","doi-asserted-by":"publisher","DOI":"10.3201\/eid2607.200885"},{"key":"S0950268821000790_ref26","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00814-16"},{"key":"S0950268821000790_ref71","doi-asserted-by":"publisher","DOI":"10.1101\/2020.04.22.20071258"},{"key":"S0950268821000790_ref56","first-page":"1837","article-title":"Turbulent gas clouds and respiratory pathogen emissions: potential implications for reducing transmission of COVID-19","volume":"323","author":"Bourouiba","year":"2020","journal-title":"JAMA"},{"key":"S0950268821000790_ref36","doi-asserted-by":"crossref","first-page":"16587","DOI":"10.1073\/pnas.2009799117","article-title":"Syrian Hamsters as a small animal model for SARS-CoV-2 infection and countermeasure development","volume":"117","author":"Imai","year":"2020","journal-title":"Proceedings of the National Academy of Sciences"},{"key":"S0950268821000790_ref68","doi-asserted-by":"publisher","DOI":"10.3947\/ic.2016.48.2.99"},{"key":"S0950268821000790_ref29","doi-asserted-by":"publisher","DOI":"10.1126\/science.abb7314"},{"key":"S0950268821000790_ref72","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30196-1"},{"key":"S0950268821000790_ref30","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-18149-6"},{"key":"S0950268821000790_ref57","doi-asserted-by":"publisher","DOI":"10.1101\/2020.02.28.20029272"},{"key":"S0950268821000790_ref64","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.02.060"},{"key":"S0950268821000790_ref84","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.1890260207"},{"key":"S0950268821000790_ref10","doi-asserted-by":"publisher","DOI":"10.3181\/00379727-122-31255"},{"key":"S0950268821000790_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa281"},{"key":"S0950268821000790_ref74","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1443"},{"key":"S0950268821000790_ref87","doi-asserted-by":"publisher","DOI":"10.1101\/2020.07.27.20162362"},{"key":"S0950268821000790_ref89","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1716561115"},{"key":"S0950268821000790_ref75","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-02893-8"},{"key":"S0950268821000790_ref47","doi-asserted-by":"publisher","DOI":"10.1126\/science.abb7015"},{"key":"S0950268821000790_ref18","doi-asserted-by":"publisher","DOI":"10.1101\/2020.04.16.044503"},{"key":"S0950268821000790_ref39","doi-asserted-by":"publisher","DOI":"10.1101\/2020.06.19.161612"},{"key":"S0950268821000790_ref59","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032867"},{"key":"S0950268821000790_ref54","unstructured":"54. World Health Organization. Coronavirus disease (COVID-19) advice for the public; Available from: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/advice-for-public [Accessed 10 June 2020]."},{"key":"S0950268821000790_ref82","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.79.1.503-511.2005"},{"key":"S0950268821000790_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(99)00334-5"},{"key":"S0950268821000790_ref90","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30160-1"},{"key":"S0950268821000790_ref55","unstructured":"55. Center for Disease Control and Prevention. Social Distancing Keep a Safe Distance to Slow the Spread. Available from: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/prevent-getting-sick\/social-distancing.html [Accessed 25 June 2020]."},{"key":"S0950268821000790_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(20)30172-5"},{"key":"S0950268821000790_ref43","doi-asserted-by":"publisher","DOI":"10.1101\/2021.01.26.21250580"},{"key":"S0950268821000790_ref53","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268806007771"},{"key":"S0950268821000790_ref31","doi-asserted-by":"publisher","DOI":"10.1101\/2020.03.21.001628"},{"key":"S0950268821000790_ref28","doi-asserted-by":"publisher","DOI":"10.1101\/2020.06.26.174128"},{"key":"S0950268821000790_ref48","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/nmicrobiol.2016.226","article-title":"A mouse model for MERS coronavirus-induced acute respiratory distress syndrome","volume":"2","author":"Cockrell","year":"2016","journal-title":"Nature Microbiology"},{"key":"S0950268821000790_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2020.03.023"},{"key":"S0950268821000790_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S0042-6822(03)00323-4"},{"key":"S0950268821000790_ref65","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2001737"},{"key":"S0950268821000790_ref85","doi-asserted-by":"publisher","DOI":"10.1084\/jem.73.1.43"},{"key":"S0950268821000790_ref91","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir442"},{"key":"S0950268821000790_ref32","doi-asserted-by":"publisher","DOI":"10.1126\/science.abc4776"},{"key":"S0950268821000790_ref33","doi-asserted-by":"publisher","DOI":"10.1101\/2020.05.17.100289"},{"key":"S0950268821000790_ref66","unstructured":"66. World Health Organization (2020) Coronavirus disease 2019 (COVID-19): situation report, 80."},{"key":"S0950268821000790_ref41","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/859090"},{"key":"S0950268821000790_ref80","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piaa037"},{"key":"S0950268821000790_ref34","doi-asserted-by":"publisher","DOI":"10.1186\/s12985-020-01396-w"},{"key":"S0950268821000790_ref50","unstructured":"50. World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations. Available from: https:\/\/www.who.int\/news-room\/commentaries\/detail\/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations. [Accessed 10 June 2020]."},{"key":"S0950268821000790_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2020.05.020"},{"key":"S0950268821000790_ref35","doi-asserted-by":"publisher","DOI":"10.1101\/2020.06.18.157933"},{"key":"S0950268821000790_ref5","doi-asserted-by":"publisher","DOI":"10.1080\/10643388409381721"},{"key":"S0950268821000790_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-93835-6_5"},{"key":"S0950268821000790_ref73","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2020.35.e142"},{"key":"S0950268821000790_ref62","doi-asserted-by":"publisher","DOI":"10.1086\/600383"},{"key":"S0950268821000790_ref76","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30232-2"},{"key":"S0950268821000790_ref63","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa033"},{"key":"S0950268821000790_ref49","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv499"},{"key":"S0950268821000790_ref61","doi-asserted-by":"publisher","DOI":"10.1089\/vim.2010.0085"},{"key":"S0950268821000790_ref58","doi-asserted-by":"publisher","DOI":"10.3201\/eid2606.200412"},{"key":"S0950268821000790_ref79","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.3651"},{"key":"S0950268821000790_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.05.027"},{"key":"S0950268821000790_ref77","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2020.07.001"},{"key":"S0950268821000790_ref42","article-title":"Does a high viral load or infectious dose make Covid-19 worse","volume":"27","author":"Geddes","year":"2020","journal-title":"New Scientist"},{"key":"S0950268821000790_ref13","first-page":"205","article-title":"The minimal infectious dose of adenovirus type 4; the case for natural transmission by viral aerosol","volume":"80","author":"Couch","year":"1969","journal-title":"Transactions of the American Clinical and Climatological Association"},{"key":"S0950268821000790_ref44","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa638"},{"key":"S0950268821000790_ref24","doi-asserted-by":"publisher","DOI":"10.1126\/science.abc4730"},{"key":"S0950268821000790_ref67","doi-asserted-by":"publisher","DOI":"10.1126\/science.1086616"},{"key":"S0950268821000790_ref17","doi-asserted-by":"publisher","DOI":"10.1101\/2020.05.29.123810"},{"key":"S0950268821000790_ref38","doi-asserted-by":"publisher","DOI":"10.1101\/2020.06.10.144188"},{"key":"S0950268821000790_ref83","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.78.7.3572-3577.2004"},{"key":"S0950268821000790_ref78","doi-asserted-by":"publisher","DOI":"10.1101\/2020.07.15.20154518"},{"key":"S0950268821000790_ref23","doi-asserted-by":"publisher","DOI":"10.1101\/2020.05.06.081497"},{"key":"S0950268821000790_ref6","volume-title":"Virology: Principles and Applications","author":"Carter","year":"2007"},{"key":"S0950268821000790_ref37","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2342-5"},{"key":"S0950268821000790_ref86","doi-asserted-by":"publisher","DOI":"10.3201\/eid1112.040949"},{"key":"S0950268821000790_ref27","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.02009-15"},{"key":"S0950268821000790_ref1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01697-15"},{"key":"S0950268821000790_ref70","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0869-5"},{"key":"S0950268821000790_ref14","first-page":"389","article-title":"Potential of attenuated respiratory syncytial virus vaccine for infants and children","volume":"28","author":"Parrott","year":"1975","journal-title":"Developments in Biological Standardization"},{"key":"S0950268821000790_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1539-6924.1999.tb01143.x"},{"key":"S0950268821000790_ref45","doi-asserted-by":"publisher","DOI":"10.3201\/eid2606.200516"},{"key":"S0950268821000790_ref19","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2312-y"},{"key":"S0950268821000790_ref88","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2020.101751"},{"key":"S0950268821000790_ref15","doi-asserted-by":"publisher","DOI":"10.1086\/655022"},{"key":"S0950268821000790_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1539-6924.2010.01427.x"},{"key":"S0950268821000790_ref69","doi-asserted-by":"publisher","DOI":"10.3201\/eid2610.202449"},{"key":"S0950268821000790_ref81","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.10.166"},{"key":"S0950268821000790_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s12560-011-9056-7"}],"updated-by":[{"DOI":"10.1017\/s0950268821001084","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000}}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268821000790","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T02:02:26Z","timestamp":1671847346000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268821000790\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":91,"alternative-id":["S0950268821000790"],"URL":"https:\/\/doi.org\/10.1017\/s0950268821000790","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2021. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e96"}}