COVID-19: disease, or no disease? - that is the question. It's the dose stupid!

The COVID-19 pandemic has raised many issues not the least of which is the reason for its high variability in consequences to the infected person. In this opinion letter, we advocate that the dose and presentation of the infecting virus is a major factor that affects whether the outcome is subclinical, tissue damaging or even lethal following infection. We briefly describe the known effects of virus dose on the course COVID-19 and discuss practical maneuvers as well as largely untested procedures that can raise the threshold dose needed to break through barriers of resistance. (C) 2021 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

The dose and presentation of the infecting virus play a crucial role in determining the outcomes of COVID-19 infection, with higher doses potentially leading to more severe consequences. Further research and testing are needed to explore practical maneuvers and untested procedures that aim to increase the threshold dose required to break through resistance barriers.