Abstract
Background: The impact of viral burden on severity and prognosis of patients hospitalized for Coronavirus Disease 2019 (COVID-19) is still a matter of debate due to controversial results. Herein, we sought to assess viral load in the nasopharyngeal swab and its association with severity score indexes and prognostic parameters.Methods: We included 127 symptomatic patients and 21 asymptomatic subjects with a diagnosis of SARS-CoV-2 infection obtained by reverse transcription polymerase chain reaction and presence of cycle threshold. According to the level of care needed during hospitalization, the population was categorized as high-intensity (HIMC, n = 76) or low intensity medical care setting (LIMC, n = 51).Results: Viral load did not differ among asymptomatic, LIMC, and HIMC SARS-CoV-2 positive patients [4.4 (2.9–5.3) vs. 4.8 (3.6–6.1) vs. 4.6 (3.9–5.7) log10 copies/ml, respectively; p = 0.31]. Similar results were observed when asymptomatic individuals were compared to hospitalized patients [4.4 (2.9–5.3) vs. 4.68 (3.8–5.9) log10 copies/ml; p = 0.13]. When the study population was divided in High (HVL, n = 64) and Low Viral Load (LVL, n = 63) group no differences were observed in disease severity at diagnosis. Furthermore, LVL and HVL groups did not differ with regard to duration of hospital stay, number of bacterial co-infections, need for high-intensity medical care and number of deaths. The viral load was not an independent risk factor for HIMC in an adjusted multivariate regression model (OR: 1.59; 95% CI: 0.46–5.55, p = 0.46).Conclusions: Viral load at diagnosis is similar in asymptomatic and hospitalized patients and is not associated with either worse outcomes during hospitalization. SARS CoV-2 viral load might not be the right tool to assist clinicians in risk-stratifying hospitalized patients.
Highlights
Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV2) is the etiological agent of the second pandemic infection of the 3rd millennium, following the H1N1 influenza outbreak in 2009
COVID-19 may cause a wide range of clinical manifestations, ranging from mild flulike symptoms with cough and fatigue to severe respiratory failure, leading to non-invasive/invasive mechanical ventilation (NIV/IMV) in the high-intensity (HIMC) or intensive medical care units (ICUs) [3]
Among subjects who were hospitalized for SARS-CoV-2 infection in the Division of Infectious and Tropical Diseases of the University Hospital of Padova between February and April 2020, we retrospectively collected 127 patients diagnosed by RTPCR at nasopharyngeal swab (NP) and with the presence of Gene E cycle threshold (Ct) in the diagnostic RT-PCR
Summary
Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV2) is the etiological agent of the second pandemic infection of the 3rd millennium, following the H1N1 influenza outbreak in 2009. This new virus, which causes Coronavirus-Disease-19 (COVID-19), rapidly spread from China, where the first cases were discovered in late December 2019. The greatest health care burden is accounted for by symptomatic patients. In this regard, COVID-19 may cause a wide range of clinical manifestations, ranging from mild flulike symptoms with cough and fatigue to severe respiratory failure, leading to non-invasive/invasive mechanical ventilation (NIV/IMV) in the high-intensity (HIMC) or intensive medical care units (ICUs) [3]. We sought to assess viral load in the nasopharyngeal swab and its association with severity score indexes and prognostic parameters
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