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. 2020 Nov;103(5):2019-2021.
doi: 10.4269/ajtmh.20-0954.

Is Higher Viral Load in SARS-CoV-2 Associated with Death?

Klinger Soares Faíco-Filho  1 , Victor Cabelho Passarelli  1 , Nancy Bellei  1
Affiliations

Is Higher Viral Load in SARS-CoV-2 Associated with Death?

Klinger Soares Faíco-Filho et al. Am J Trop Med Hyg. 2020 Nov.

Abstract

There is no proven prognostic marker for patients hospitalized with COVID-19. We conducted a retrospective cohort study of patients hospitalized with COVID-19 from March 14, 2020 to June 17, 2020, at São Paulo Hospital, in São Paulo, Brazil. SARS-CoV-2 viral load was assessed using the cycle threshold (Ct) values obtained from a reverse transcription-PCR assay applied to the nasopharyngeal swab samples. The reactions were performed following the CDC U.S. protocol targeting the N1 and N2 sequences of the SARS-CoV-2 nucleoprotein gene and human ribonuclease P gene serving as an endogenous control. Disease severity and patient outcomes were compared. Among 875 patients, 50.1% (439/875) were categorized as having mild disease (nonhospitalized patients), 30.4% (266/875) moderate (hospitalized in the ward), and 19.5% (170/875) severe disease (admitted to the intensive care unit). A Ct value of < 25 (472/875) indicated a high viral load, which was independently associated with mortality (odds ratio [OR]: 2.93; 95% CI: 1.87-4.60; P < 0.0001). We concluded that admission SARS-CoV-2 viral load was independently associated with mortality among patients hospitalized with COVID-19.

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Figures

Figure 1.
Figure 1.
Initial cycle threshold (Ct) values from the swab samples in different age-groups.
Figure 2.
Figure 2.
Initial cycle threshold (Ct) values from the swab samples obtained from patients with different clinical outcomes.
Figure 3.
Figure 3.
Cycle threshold (Ct) values from the swab samples according to discharge or death.
See this image and copyright information in PMC

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