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Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study
BACKGROUND: We assessed the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and hospital admission, intensive care unit (ICU) admission, and in-hospital mortality. METHODS: All SARS-CoV-2–positive persons with a combined nasopharyngeal and oropharyngeal sw...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272435/ https://www.ncbi.nlm.nih.gov/pubmed/35821732 http://dx.doi.org/10.1093/ofid/ofac223 |
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author | Souverein, Dennis van Stralen, Karlijn van Lelyveld, Steven van Gemeren, Claudia Haverkort, Milly Snijders, Dominic Soetekouw, Robin Kapteijns, Erik de Jong, Evelien Hermanides, Gonneke Aronson, Sem Herpers, Bjorn den Boer, Jeroen Wagemakers, Alex Euser, Sjoerd |
author_facet | Souverein, Dennis van Stralen, Karlijn van Lelyveld, Steven van Gemeren, Claudia Haverkort, Milly Snijders, Dominic Soetekouw, Robin Kapteijns, Erik de Jong, Evelien Hermanides, Gonneke Aronson, Sem Herpers, Bjorn den Boer, Jeroen Wagemakers, Alex Euser, Sjoerd |
author_sort | Souverein, Dennis |
collection | PubMed |
description | BACKGROUND: We assessed the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and hospital admission, intensive care unit (ICU) admission, and in-hospital mortality. METHODS: All SARS-CoV-2–positive persons with a combined nasopharyngeal and oropharyngeal swab that was collected between 17 March 2020 and 31 March 2021 in public health testing facilities were included. RESULTS: From 20 207 SARS-CoV-2–positive persons, 310 (1.5%) were hospitalized within 30 days. High viral loads (crossing point [Cp] <25) were associated with an increased risk of hospitalization as compared to low viral loads (Cp >30), adjusted for age and sex (adjusted odds ratio [aOR], 1.57 [95% confidence interval {CI}, 1.11–2.26]). The same association was seen for ICU admission (aOR, 7.06 [95% CI, 2.15–43.57]). The median [interquartile range] Cp value of the 17 patients who died in hospital was significantly lower compared to the 226 survivors (22.7 [3.4] vs 25.0 [5.2]). CONCLUSIONS: Higher initial SARS-CoV-2 viral load is associated with an increased risk of hospital admission, ICU admission, and in-hospital mortality. Our findings emphasize the added value of reporting SARS-CoV-2 viral load or cycle threshold/Cp values to identify persons who are at the highest risk of adverse outcomes such as hospital or ICU admission and who therefore may benefit from more intensive monitoring or early initiation of antiviral therapy. |
format | Online Article Text |
id | pubmed-9272435 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-92724352022-07-11 Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study Souverein, Dennis van Stralen, Karlijn van Lelyveld, Steven van Gemeren, Claudia Haverkort, Milly Snijders, Dominic Soetekouw, Robin Kapteijns, Erik de Jong, Evelien Hermanides, Gonneke Aronson, Sem Herpers, Bjorn den Boer, Jeroen Wagemakers, Alex Euser, Sjoerd Open Forum Infect Dis Major Article BACKGROUND: We assessed the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and hospital admission, intensive care unit (ICU) admission, and in-hospital mortality. METHODS: All SARS-CoV-2–positive persons with a combined nasopharyngeal and oropharyngeal swab that was collected between 17 March 2020 and 31 March 2021 in public health testing facilities were included. RESULTS: From 20 207 SARS-CoV-2–positive persons, 310 (1.5%) were hospitalized within 30 days. High viral loads (crossing point [Cp] <25) were associated with an increased risk of hospitalization as compared to low viral loads (Cp >30), adjusted for age and sex (adjusted odds ratio [aOR], 1.57 [95% confidence interval {CI}, 1.11–2.26]). The same association was seen for ICU admission (aOR, 7.06 [95% CI, 2.15–43.57]). The median [interquartile range] Cp value of the 17 patients who died in hospital was significantly lower compared to the 226 survivors (22.7 [3.4] vs 25.0 [5.2]). CONCLUSIONS: Higher initial SARS-CoV-2 viral load is associated with an increased risk of hospital admission, ICU admission, and in-hospital mortality. Our findings emphasize the added value of reporting SARS-CoV-2 viral load or cycle threshold/Cp values to identify persons who are at the highest risk of adverse outcomes such as hospital or ICU admission and who therefore may benefit from more intensive monitoring or early initiation of antiviral therapy. Oxford University Press 2022-05-01 /pmc/articles/PMC9272435/ /pubmed/35821732 http://dx.doi.org/10.1093/ofid/ofac223 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Major Article Souverein, Dennis van Stralen, Karlijn van Lelyveld, Steven van Gemeren, Claudia Haverkort, Milly Snijders, Dominic Soetekouw, Robin Kapteijns, Erik de Jong, Evelien Hermanides, Gonneke Aronson, Sem Herpers, Bjorn den Boer, Jeroen Wagemakers, Alex Euser, Sjoerd Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study |
title | Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study |
title_full | Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study |
title_fullStr | Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study |
title_full_unstemmed | Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study |
title_short | Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study |
title_sort | initial severe acute respiratory syndrome coronavirus 2 viral load is associated with disease severity: a retrospective cohort study |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272435/ https://www.ncbi.nlm.nih.gov/pubmed/35821732 http://dx.doi.org/10.1093/ofid/ofac223 |
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