To measure viral load in participants with COVID-19 and rule out asymptomatic infection in controls, quantitative reverse transcription PCR in all mid-turbinate swabs collected at enrolment using United States Centers for Disease Control and Prevention primers and probes designed for the detection of SARS-CoV-2 was performed [16 (link)]. High viral load was defined as a cycle threshold value for the detection of the coronavirus nucleocapsid gene region 1 below the median of all samples collected at enrolment (day 1) from SARS-CoV-2-infected participants.