Abstract
The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome.
Highlights
The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes
Fifty-six (17.4%) patients had a mild disease and were discharged after the first evaluation, and subsequently attended as outpatients until the end of follow-up; 180 (56.1%) had a moderate course, being hospitalized in general wards, and with full recovery and hospital discharged; and 85 (26.5%) patients were categorized as severe COVID-19 because of required admission to the intensive care unit (ICU) (32 patients [10.0%]), in-hospital death (40 [12.5%]), or both (13 [4.0%])
The main finding of the present study is that patients with SARS-CoV-2 infection, regardless of their illness severity, generally have a high rate of viral replication in the upper respiratory airways
Summary
The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log[10] copies/mL, p = 0.003) and second tertile (≥ 8.27 log[10] copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. In the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome. Different studies have already addressed this issue, identifying clinical signs and several biomarkers as predictors of unfavorable outcome[5,6,7] In this regard, different studies have addressed the possible association between the viral load in nasopharyngeal (NP) swabs and the clinical outcomes. Of initial SARS-CoV-2 viral load in NP swabs on COVID-19 patients’ outcomes is not been fully elucidated, and this issue remains c ontroversial[14]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
