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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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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
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author 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
author_facet 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
author_sort Boef, Anna G.C.
collection PubMed
description 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.
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spelling pubmed-80616352021-04-23 Viral load dynamics in intubated patients with COVID-19 admitted to the intensive care unit 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 J Crit Care Article 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. The Authors. Published by Elsevier Inc. 2021-08 2021-04-22 /pmc/articles/PMC8061635/ /pubmed/34023553 http://dx.doi.org/10.1016/j.jcrc.2021.04.010 Text en © 2021 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 Article
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
Viral load dynamics in intubated patients with COVID-19 admitted to the intensive care unit
title Viral load dynamics in intubated patients with COVID-19 admitted to the intensive care unit
title_full Viral load dynamics in intubated patients with COVID-19 admitted to the intensive care unit
title_fullStr Viral load dynamics in intubated patients with COVID-19 admitted to the intensive care unit
title_full_unstemmed Viral load dynamics in intubated patients with COVID-19 admitted to the intensive care unit
title_short Viral load dynamics in intubated patients with COVID-19 admitted to the intensive care unit
title_sort viral load dynamics in intubated patients with covid-19 admitted to the intensive care unit
topic Article
url 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
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