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Within-host SARS-CoV-2 modelling studies have been published throughout the COVID-19 pandemic. These studies contain highly variable numbers of individuals and capture varying timescales of pathogen dynamics; some studies capture the time of disease onset, the peak viral load and subsequent heterogeneity in clearance dynamics across individuals, while others capture late-time post-peak dynamics. In this study, we curate multiple previously published SARS-CoV-2 viral load data sets, fit these data with a consistent modelling approach, and estimate the variability of in-host parameters including the basic reproduction number, 𝑅0, as well as the best-fit eclipse phase profile. We find that fitted dynamics can be highly variable across data sets, and highly variable within data sets, particularly when key components of the dynamic trajectories (e.g. peak viral load) are not represented in the data. Further, we investigated the role of the eclipse phase time distribution in fitting SARS-CoV-2 viral load data. By varying the shape parameter of an Erlang distribution, we demonstrate that models with either no eclipse phase, or with an exponentially-distributed eclipse phase, offer significantly worse fits to these data, whereas models with less dispersion around the mean eclipse time (shape parameter two or more) offered the best fits to the available data across all data sets used in this work. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".

Highlights • Mathematical model to represent viral dynamics in COVID-19 patients. • Stability Analysis in COVID-19 Within-Host Model • Bifurcation analysis suggests that the virus replicates fast to overcome T cells., The 2019 coronavirus disease (COVID-19) is now a global pandemic. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the causative pathogen of COVID-19. Here, we study an in-host model that highlights the effector T cell response to SARS-CoV-2. The stability of a unique positive equilibrium point, with viral load V*, suggests that the virus may replicate fast enough to overcome T cell response and cause infection. This overcoming is the bifurcation point, near which the orders of magnitude for V* can be sensitive to numerical changes in the parameter values. Our work offers a mathematical insight into how SARS-CoV-2 causes the disease.