Lack of Association of Initial Viral Load in SARS-CoV-2 Patients with In-Hospital Mortality.
Lack of Association of Initial Viral Load in SARS-CoV-2 Patients with In-Hospital Mortality.
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DOI：
10.4269/ajtmh.20-1427
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发表时间：
2020-12-23
期刊：
影响因子：
--
通讯作者：
Bardají A
中科院分区：
文献类型：
--
作者：
Carrasquer A;Peiró ÓM;Sanchez-Gimenez R;Lal-Trehan N;Del-Moral-Ronda V;Bonet G;Gutierrez C;Fort-Gallifa I;Martin-Grau C;Benavent C;Vidal F;Bardají A
关于鼻咽SARS-CoV-2病毒载量可能的预后影响，文献中存在争议。我们对169例患者进行了回顾性观察研究，其中96例（58.9%）病毒载量高，其余患者病毒载量低。与低病毒载量患者相比，高病毒载量患者在既存心血管危险因素或合并症方面没有表现出差异。两组的症状、生命体征或实验室检查结果均无差异，但心肌肌钙蛋白I（cTnI）最大值在病毒载量较高的组中较高（24 [四分位距9.5-58.5] vs 8.5 [四分位距3-22.5] ng/L，P = 0.007）。在住院、入住重症监护室或临床管理中机械通气的需求方面没有差异。高病毒载量患者的住院死亡率高于低病毒载量患者（24% vs 10.4%，P = 0.029）。在二元logistic回归分析中，高病毒载量与院内死亡率相关（比值比：2.701，95% Charlson指数（CI）：1.084-6.725，P = 0.033）。然而，在一项调整了年龄、性别、CI和cTnI的分析中，病毒载量不再是死亡率的预测因子。总之，鼻咽病毒载量升高不是COVID-19患者住院死亡率的决定因素，而年龄、合并症和心肌损伤（由cTnI升高决定）则是决定因素。
Controversy exists in the literature regarding the possible prognostic implications of the nasopharyngeal SARS-CoV-2 viral load. We carried out a retrospective observational study of 169 patients, 96 (58.9%) of whom had a high viral load and the remaining had a low viral load. Compared with patients with a low viral load, patients with a high viral load did not exhibit differences regarding preexisting cardiovascular risk factors or comorbidities. There were no differences in symptoms, vital signs, or laboratory tests in either group, except for the maximum cardiac troponin I (cTnI), which was higher in the group with a higher viral load (24 [interquartile range 9.5–58.5] versus 8.5 [interquartile range 3–22.5] ng/L, P = 0.007). There were no differences in the need for hospital admission, admission to the intensive care unit, or the need for mechanical ventilation in clinical management. In-hospital mortality was greater in patients who had a higher viral load than in those with low viral load (24% versus 10.4%, P = 0.029). High viral loads were associated with in-hospital mortality in the binary logistic regression analysis (odds ratio: 2.701, 95% Charlson Index (CI): 1.084–6.725, P = 0.033). However, in an analysis adjusted for age, gender, CI, and cTnI, viral load was no longer a predictor of mortality. In conclusion, an elevated nasopharyngeal viral load was not a determinant of in-hospital mortality in patients with COVID-19, as much as age, comorbidity, and myocardial damage determined by elevated cTnI are.
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DOI：
10.1515/almed-2020-0059
发表时间：
2021-05
期刊：
Advances in laboratory medicine
影响因子：
--
作者：
通讯作者：
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影响因子：
12.7
作者：
Micheli, Valeria;Rimoldi, Sara G.;Gismondo, Maria R.
通讯作者：
Gismondo, Maria R.
DOI：
10.1164/rccm.202002-0445oc
发表时间：
2020-06-01
影响因子：
24.7
作者：
Feng, Yun;Ling, Yun;Qu, Jieming
通讯作者：
Qu, Jieming
影响因子：
3.4
作者：
Uribarri, Aitor;Nunez-Gil, Ivan J.;Estrada, Vicente
通讯作者：
Estrada, Vicente
影响因子：
14.6
作者：
Chu, CM;Poon, LLM;Yuen, KY
通讯作者：
Yuen, KY