Causal, Bayesian, & Non-parametric Modeling of the SARS-CoV-2 Viral Load Distribution vs. Patient's Age

TL;DR

This paper introduces a flexible Bayesian causal model to analyze how SARS-CoV-2 viral load distribution varies with age, testing for bias and revealing a significant increase with age in one dataset, impacting understanding of infectivity.

Contribution

It develops a novel non-parametric Bayesian causal framework for analyzing viral load data as a function of age, including bias detection, and applies it to SARS-CoV-2 data.

Findings

Viral load increases with age in one dataset.

Bias testing indicates potential data collection issues.

Age-related viral load differences may affect infectivity assessments.

Abstract

The viral load of patients infected with SARS-CoV-2 varies on logarithmic scales and possibly with age. Controversial claims have been made in the literature regarding whether the viral load distribution actually depends on the age of the patients. Such a dependence would have implications for the COVID-19 spreading mechanism, the age-dependent immune system reaction, and thus for policymaking. We hereby develop a method to analyze viral-load distribution data as a function of the patients' age within a flexible, non-parametric, hierarchical, Bayesian, and causal model. The causal nature of the developed reconstruction additionally allows to test for bias in the data. This could be due to, e.g., bias in patient-testing and data collection or systematic errors in the measurement of the viral load. We perform these tests by calculating the Bayesian evidence for each implied possible causal direction. The possibility of testing for bias in data collection and identifying causal directions can be very useful in other contexts as well. For this reason we make our model freely available. When applied to publicly available age and SARS-CoV-2 viral load data, we find a statistically significant increase in the viral load with age, but only for one of the two analyzed datasets. If we consider this dataset, and based on the current understanding of viral load's impact on patients' infectivity, we expect a non-negligible difference in the infectivity of different age groups. This difference is nonetheless too small to justify considering any age group as noninfectious.