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Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy

OBJECTIVES: In Italy the burden of patients with coronavirus disease 2019 (COVID-19) gradually decreased from March to the end of May. In this work we aimed to evaluate a possible association between the severity of clinical manifestations and viral load over time during the epidemiological transiti...

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Autores principales: Piubelli, Chiara, Deiana, Michela, Pomari, Elena, Silva, Ronaldo, Bisoffi, Zeno, Formenti, Fabio, Perandin, Francesca, Gobbi, Federico, Buonfrate, Dora
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7548572/
https://www.ncbi.nlm.nih.gov/pubmed/33059091
http://dx.doi.org/10.1016/j.cmi.2020.10.006
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author Piubelli, Chiara
Deiana, Michela
Pomari, Elena
Silva, Ronaldo
Bisoffi, Zeno
Formenti, Fabio
Perandin, Francesca
Gobbi, Federico
Buonfrate, Dora
author_facet Piubelli, Chiara
Deiana, Michela
Pomari, Elena
Silva, Ronaldo
Bisoffi, Zeno
Formenti, Fabio
Perandin, Francesca
Gobbi, Federico
Buonfrate, Dora
author_sort Piubelli, Chiara
collection PubMed
description OBJECTIVES: In Italy the burden of patients with coronavirus disease 2019 (COVID-19) gradually decreased from March to the end of May. In this work we aimed to evaluate a possible association between the severity of clinical manifestations and viral load over time during the epidemiological transition from high-to low-transmission settings. METHODS: We reviewed the cases of COVID-19 diagnosed at the emergency room of our hospital, retrieving the proportion of patients admitted to the intensive care unit. A raw estimation of the viral load was done evaluating the Ct (cycle threshold) trend obtained from our diagnostic reverse transcriptase real-time PCR test. RESULTS: The proportion of patients requiring intensive care significantly decreased from 6.7% (19/281) in March to 1.1% (1/86) in April, and to none in May (Fisher's test p 0.0067). As for viral load, we observed a trend of Ct increasing from a median value of 24 (IQR 19–29) to 34 (IQR 29–37) between March and May, with a statistically significant difference between March and April (pairwise Wilcoxon test with stepdown Bonferroni adjustment for multiple testing, p 0.0003). CONCLUSIONS: We observed a reduction over time in the proportion of patients with COVID-19 requiring intensive care, along with decreasing median values of viral load. As the epidemiological context changes from high-to low-transmission settings, people are presumably exposed to a lower viral load which has been previously associated with less severe clinical manifestations.
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spelling pubmed-75485722020-10-13 Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy Piubelli, Chiara Deiana, Michela Pomari, Elena Silva, Ronaldo Bisoffi, Zeno Formenti, Fabio Perandin, Francesca Gobbi, Federico Buonfrate, Dora Clin Microbiol Infect Research Note OBJECTIVES: In Italy the burden of patients with coronavirus disease 2019 (COVID-19) gradually decreased from March to the end of May. In this work we aimed to evaluate a possible association between the severity of clinical manifestations and viral load over time during the epidemiological transition from high-to low-transmission settings. METHODS: We reviewed the cases of COVID-19 diagnosed at the emergency room of our hospital, retrieving the proportion of patients admitted to the intensive care unit. A raw estimation of the viral load was done evaluating the Ct (cycle threshold) trend obtained from our diagnostic reverse transcriptase real-time PCR test. RESULTS: The proportion of patients requiring intensive care significantly decreased from 6.7% (19/281) in March to 1.1% (1/86) in April, and to none in May (Fisher's test p 0.0067). As for viral load, we observed a trend of Ct increasing from a median value of 24 (IQR 19–29) to 34 (IQR 29–37) between March and May, with a statistically significant difference between March and April (pairwise Wilcoxon test with stepdown Bonferroni adjustment for multiple testing, p 0.0003). CONCLUSIONS: We observed a reduction over time in the proportion of patients with COVID-19 requiring intensive care, along with decreasing median values of viral load. As the epidemiological context changes from high-to low-transmission settings, people are presumably exposed to a lower viral load which has been previously associated with less severe clinical manifestations. The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. 2021-01 2020-10-12 /pmc/articles/PMC7548572/ /pubmed/33059091 http://dx.doi.org/10.1016/j.cmi.2020.10.006 Text en © 2020 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Research Note
Piubelli, Chiara
Deiana, Michela
Pomari, Elena
Silva, Ronaldo
Bisoffi, Zeno
Formenti, Fabio
Perandin, Francesca
Gobbi, Federico
Buonfrate, Dora
Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy
title Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy
title_full Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy
title_fullStr Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy
title_full_unstemmed Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy
title_short Overall decrease in SARS-CoV-2 viral load and reduction in clinical burden: the experience of a hospital in northern Italy
title_sort overall decrease in sars-cov-2 viral load and reduction in clinical burden: the experience of a hospital in northern italy
topic Research Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7548572/
https://www.ncbi.nlm.nih.gov/pubmed/33059091
http://dx.doi.org/10.1016/j.cmi.2020.10.006
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