SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome.
SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome.
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DOI：
10.1038/s41598-021-92400-y
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发表时间：
2021-06-21
影响因子：
4.6
通讯作者：
Virgen del Rocío Hospital COVID-19 Working Team
中科院分区：
文献类型：
--
作者：
Salto-Alejandre S;Berastegui-Cabrera J;Camacho-Martínez P;Infante-Domínguez C;Carretero-Ledesma M;Crespo-Rivas JC;Márquez E;Lomas JM;Bueno C;Amaya R;Lepe JA;Cisneros JM;Pachón J;Cordero E;Sánchez-Céspedes J;Virgen del Rocío Hospital COVID-19 Working Team
目的是评估鼻咽SARS-CoV-2病毒载量在第一个患者的医院评估预测不利结果的能力。我们进行了一项前瞻性队列研究，包括321例通过鼻咽拭子RT-PCR确诊的COVID-19成人患者。使用定量合成SARS-CoV-2 RNA循环阈值计算病毒载量（log 10拷贝/mL）。随访结束时的疾病严重程度分为轻度、中度和重度。主要终点是重症监护室（ICU）入院和/或死亡的复合终点（n = 85，26.4%）。进行单变量和多变量logistic回归分析。在未校正的logistic回归分析中，鼻咽SARS-CoV-2病毒载量超过第二四分位数（≥ 7.35 log 10拷贝/mL，p = 0.003）和第二三分位数（≥ 8.27 log 10拷贝/mL，p = 0.01）与不良结局相关。然而，在最终的多变量分析中，病毒载量与不良结局无关。5个预测因素与ICU入院和/或死亡的几率增加独立相关：年龄≥ 70岁、SpO 2、中性粒细胞> 7.5 × 103/µL、乳酸脱氢酶≥ 300 U/L和C反应蛋白≥ 100 mg/L。总之，COVID-19患者入院时鼻咽SARS-CoV-2病毒载量通常较高，无论疾病严重程度如何，但它不能作为不利临床结局的独立预测因素。
The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome.
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