Association Between Upper Respiratory Tract Viral Load, Comorbidities, Disease Severity, and Outcome of Patients With SARS-CoV-2 Infection
Association Between Upper Respiratory Tract Viral Load, Comorbidities, Disease Severity, and Outcome of Patients With SARS-CoV-2 Infection
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DOI：
10.1093/infdis/jiaa804
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发表时间：
2021-01-31
影响因子：
6.4
通讯作者：
Tsakris, Athanasios
中科院分区：
文献类型：
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作者：
Maltezou, Helena C.;Raftopoulos, Vasilios;Tsakris, Athanasios
背景关于SARS-CoV-2感染患者的上呼吸道（URT）病毒载量、宿主因素和疾病严重程度之间的关系的信息有限。我们研究了1122例患者（平均年龄46岁）诊断聚合酶链反应（PCR）。URT病毒载量，PCR循环阈值测量，分为高，中，低。336例（29.9%）患者存在合并症; 309例（27.5%）患者病毒载量较高，316例（28.2%）患者病毒载量中等，497例（44.3%）患者病毒载量较低。在单变量分析中，与中等或低病毒载量的患者相比，高病毒载量的患者年龄更大，更常合并症，发生症状性疾病（COVID-19），插管和死亡。与低病毒载量患者相比，高病毒载量患者在重症监护室的停留时间更长，插管时间更长（所有比较的P值<0.05）。慢性心血管疾病、高血压、慢性肺病、免疫抑制、肥胖和慢性神经系统疾病患者的病毒载量更高（所有比较的P值<0.05）。在多变量分析中，高病毒载量与COVID-19相关。病毒载量水平与其他结果无关。URT病毒载量可用于识别发病或严重结局风险较高的患者。
Background. There is limited information on the association between upper respiratory tract (URT) viral loads, host factors, and disease severity in SARS-CoV-2-infected patients.Methods. We studied 1122 patients (mean age, 46 years) diagnosed by polymerase chain reaction (PCR). URT viral load, measured by PCR cycle threshold, was categorized as high, moderate, or low.Results. There were 336 (29.9%) patients with comorbidities; 309 patients (27.5%) had high, 316 (28.2%) moderate, and 497 (44.3%) low viral load. In univariate analyses, compared to patients with moderate or low viral load, patients with high viral load were older, more often had comorbidities, developed Symptomatic disease (COVID-19), were intubated, and died. Patients with high viral load had longer stay in intensive care unit and longer intubation compared to patients with low viral load (P values < .05 for all comparisons). Patients with chronic cardiovascular disease, hypertension, chronic pulmonary disease, immunosuppression, obesity, and chronic neurological disease more often had high viral load (P value < .05 for all comparisons). In multivariate analysis high viral load was associated with COVID-19. Level of viral load was not associated with any other outcome.Conclusions. URT viral load could be used to identify patients at higher risk for morbidity or severe outcome.