Viral load and disease severity in COVID-19.

Autor: Pawar RD; Division of Hospital Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA, 02215, USA. rpawar@bidmc.harvard.edu.; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. rpawar@bidmc.harvard.edu., Balaji L; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Mehta S; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Cole A; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Liu X; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Peradze N; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Grossestreuer AV; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Issa MS; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Patel P; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Kirby JE; Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Rowley CF; Division of Infectious Disease, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Berg KM; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Moskowitz A; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Donnino MW; Department of Emergency Medicine, Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2022 Mar; Vol. 17 (2), pp. 359-367. Date of Electronic Publication: 2021 Jun 16.
DOI: 10.1007/s11739-021-02786-w
Abstrakt: The relationship between COVID-19 severity and viral load is unknown. Our objective was to assess the association between viral load and disease severity in COVID-19. In this single center observational study of adults with laboratory confirmed SARS-CoV-2, the first positive in-hospital nasopharyngeal swab was used to calculate the log10 copies/ml [log10 copy number (CN)] of SARS-CoV-2. Four categories based on level of care and modified sequential organ failure assessment score (mSOFA) at time of swab were determined. Median log10CN was compared between different levels of care and mSOFA quartiles. Median log10CN was compared in patients who did and did not receive influenza vaccine, and the correlation between log10CN and D-dimer was examined. We found that of 396 patients, 54.3% were male, and 25% had no major comorbidity. Hospital mortality was 15.7%. Median mSOFA was 2 (IQR 0-3). Median log10CN was 5.5 (IQR 3.3-8.0). Median log10CN was highest in non-intubated ICU patients [6.4 (IQR 4.4-8.1)] and lowest in intubated ICU patients [3.6 (IQR 2.6-6.9)] (p value < 0.01). In adjusted analyses, this difference remained significant [mean difference 1.16 (95% CI 0.18-2.14)]. There was no significant difference in log10CN between other groups in the remaining pairwise comparisons. There was no association between median log10CN and mSOFA in either unadjusted or adjusted analyses or between median log10CN in patients with and without influenza immunization. There was no correlation between log10CN and D-dimer. We conclude, in our cohort, we did not find a clear association between viral load and disease severity in COVID-19 patients. Though viral load was higher in non-intubated ICU patients than in intubated ICU patients there were no other significant differences in viral load by disease severity.
(© 2021. Società Italiana di Medicina Interna (SIMI).)
Databáze: MEDLINE
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