biostudies-literatureFisher LHBLRD VANIA NIH HHSNIAID NIH HHSe2412835https://www.ebi.ac.uk/biostudies/studies/S-EPMC11117088biostudies-literatureUnknown7(5)<h4>Importance</h4>SARS-CoV-2 viral load (VL) in the nasopharynx is difficult to quantify and standardize across settings, but it may inform transmission potential and disease severity.<h4>Objective</h4>To characterize VL at COVID-19 diagnosis among previously uninfected and unvaccinated individuals by evaluating the association of demographic and clinical characteristics, viral variant, and trial with VL, as well as the ability of VL to predict severe disease.<h4>Design, setting, and participants</h4>This secondary cross-protocol analysis used individual-level data from placebo recipients from 4 harmonized, phase 3 COVID-19 vaccine efficacy trials sponsored by Moderna, AstraZeneca, Janssen, and Novavax. 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JPRouhbakhsh REder FSShankaran SManning RDBenitez JAOlmos Vega JZPellecchia AAlvarez Leon WSMcKeown-Bragas CGonzales-Zamora JJones-Lopez ECPeay AKFalk AShaw MENyaku AFearon SSadoff JJahromi MGoecker EANoor AHull CGipson TKamidani SSchwartz HKeitel WAAnthony CMCarmody ESchwartz AZhai NSmith WBWohl DSmith CFry JSchwartz JDunbar DUsdan LSBecerra MGKogelman LSmith KBurgett MLDunbar HRankin BGGrant ABranche ARZervos MJSmith MLilienthal ACooper DSwan SEnsz DJCarsons SEBunce CABoscia JLord JPatel AOcana ESanchez Guerrero LRMackey NWilliams HNofz KGharib SRiddler SAFinkelstein KGharib EBorgetti SSchnitz WPatel PAnderson CGDavis MGAleman LFrank ITapia MUtz GCAckerman JGibson RLGalloway CBalani BHan-Conrad LJHorwith GZash RBerthaud VAckerman RRiesenberg REl Sahly HMCancilla MDubovsky FWilliams SBrandenburg BDuhart ASciaudone MHamilton HMalvestutto CHaughey LAAtmar RLHarshell SBauer GHLawler DTAlcaide MLde Groot AMWalter EBThomas-Seaton LDunlevy HBocchini JHall EHartvickson RAmador CMoodley 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LGottschlich GMCallis JMena JMDavis WBEdupuganti SChacon JAKing MPeterson JTNewton FEDavis WSTakizala ZMBarrat Hernandez AQBaron MCampbell WCorral BPalmer SConway JHBradley PSBlumenthal JLeathers VDong JLEspinosa CMJeanfreau RCross MAGriffin CPJeanfreau SStephenson KEfalseSARS-CoV-2 Viral Load in the Nasopharynx at Time of First Infection Among Unvaccinated Individuals: A Secondary Cross-Protocol Analysis of 4 Randomized Trials.<h4>Importance</h4>SARS-CoV-2 viral load (VL) in the nasopharynx is difficult to quantify and standardize across settings, but it may inform transmission potential and disease severity.<h4>Objective</h4>To characterize VL at COVID-19 diagnosis among previously uninfected and unvaccinated individuals by evaluating the association of demographic and clinical characteristics, viral variant, and trial with VL, as well as the ability of VL to predict severe disease.<h4>Design, setting, and participants</h4>This secondary cross-protocol analysis used individual-level data from placebo recipients from 4 harmonized, phase 3 COVID-19 vaccine efficacy trials sponsored by Moderna, AstraZeneca, Janssen, and Novavax. Participants were SARS-CoV-2 negative at baseline and acquired COVID-19 during the bli2024-01-01T00:00:00Z2024 May2026-06-02T19:58:54.638Z2026-04-19T03:14:01.498ZS-EPMC111170883878094110.1001/jamanetworkopen.2024.12835