Background and Objective: Although coronavirus disease 2019 (COVID-19) is no longer considered a global health emergency, it remains an important threat because of the persistently high number of infections, hospitalizations, and fatalities caused by repeated waves of new variants. Identifying factors that can aid in clinical decision making and public health interventions to mitigate the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) must hence be prioritized. Therefore, we present here a narrative review to discuss the drawbacks and emphasize the important advantages of continuing to report the viral load in upper respiratory tract specimens in individuals with SARS-CoV-2 infection. Methods: This narrative review discusses the drawbacks and, in particular, highlights the important advantages of continuing to report viral load in upper respiratory tract specimens collected from individuals infected with SARS-CoV-2 after the global emergency phase has ended. Key Content and Findings: Measurement of SARS-CoV-2 viral load (i.e., most commonly the cycle threshold) in upper respiratory tract specimens is subject to several limitations, the most important of which is poor interlaboratory comparability, especially when different nucleic acid amplification tests are used. Nevertheless, routine determination and reporting of viral load in persons with SARS-CoV-2 infection may have some important advantages. These essentially include the association with a number of epidemiologic, biologic, and clinical aspects, as this measure can predict disease severity, population epidemic, future public health burden, emergence of new variants, individual infectivity and shedding kinetics, as well as the risk of developing long-COVID. Conclusions: Routine viral load determination and reporting in patients with SARS-CoV-2 infection could offer significant advantages that may outweigh the current technical limitations.
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