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Viral load dynamics in intubated patients with COVID-19 admitted to the intensive care unit

BACKGROUND: Prolonged viral RNA detection in respiratory samples from patients with COVID-19 has been described, but the clinical relevance remains unclear. We studied the dynamics of SARS-CoV-2 on a group and individual level in intubated ICU patients. METHODS: In a cohort of 86 patients, we analys...

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Detalles Bibliográficos
Autores principales: Boef, Anna G.C., van Wezel, Esther M., Gard, Lilli, Netkova, Kala, Lokate, Mariëtte, van der Voort, Peter H.J., Niesters, Hubert G.M., Van Leer Buter, Coretta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061635/
https://www.ncbi.nlm.nih.gov/pubmed/34023553
http://dx.doi.org/10.1016/j.jcrc.2021.04.010
Descripción
Sumario:BACKGROUND: Prolonged viral RNA detection in respiratory samples from patients with COVID-19 has been described, but the clinical relevance remains unclear. We studied the dynamics of SARS-CoV-2 on a group and individual level in intubated ICU patients. METHODS: In a cohort of 86 patients, we analysed SARS-CoV-2 RT-PCR results on nasopharyngeal and sputum samples (obtained as part of clinical care twice a week) according to time after intubation. Subsequently, we performed survival analyses. RESULTS: 870 samples were tested by RT-PCR. Overall viral load was highest in the first week (median nasopharynx 3.5, IQR 1.5–4.3; median sputum 4.3, IQR 3.3–5.6) and decreased over time. In 20% of patients a relapsing pattern was observed. Nasopharyngeal and sputum PCR status on day 14 was not significantly associated with survival up to day 60 in this small cohort. CONCLUSION: In general SARS-CoV-2 RNA levels in respiratory samples in patients with severe COVID-19 decrease after the first week after intubation, but individual SARS-CoV-2 RNA levels can show a relapsing pattern. Larger studies are needed to address the association of clearance of SARS-CoV-2 RNA from respiratory samples with survival, because we observed a trend towards better survival in patients with early clearance from sputum.