Impact of viral load at admission on the development of respiratory failure in hospitalized patients with SARS-CoV-2 infection
The aim of our study was to elucidate if SARS-CoV-2 viral load on admission, measured by real-time reverse transcriptase–polymerase chain reaction (rRT-PCR) cycle threshold (Ct) value on nasopharyngeal samples, was a marker of disease severity. All hospitalized adult patients with a diagnosis of SAR...
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| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2021-06, Vol.40 (6), p.1209-1216 |
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| creator | de la Calle, Cristina Lalueza, Antonio Mancheño-Losa, Mikel Maestro-de la Calle, Guillermo Lora-Tamayo, Jaime Arrieta, Estibaliz García-Reyne, Ana Losada, Irene de Miguel, Borja Díaz-Simón, Raquel López-Medrano, Francisco Fernández-Ruiz, Mario Carretero, Octavio San Juan, Rafael Aguado, José María Lumbreras, Carlos |
| description | The aim of our study was to elucidate if SARS-CoV-2 viral load on admission, measured by real-time reverse transcriptase–polymerase chain reaction (rRT-PCR) cycle threshold (Ct) value on nasopharyngeal samples, was a marker of disease severity. All hospitalized adult patients with a diagnosis of SARS-CoV-2 infection by rRT-PCR performed on a nasopharingeal sample from March 1 to March 18 in our institution were included. The study population was divided according to the Ct value obtained upon admission in patients with high viral load (Ct 30). Demographic, clinical and laboratory variables of the different groups were analyzed to assess the influence of viral load on the development of respiratory failure during admission. Overall, 455 sequential patients were included. The median Ct value was 28 (IQR: 24–32). One hundred and thirty patients (28.6%) had a high viral load, 175 (38.5%) an intermediate viral load and 150 (33%) a low viral load. Advanced age, male sex, presence of cardiovascular disease and laboratory markers such as lactate dehydrogenase, lymphocyte count and C-reactive protein, as well as a high viral load on admission, were predictive of respiratory failure. A Ct value |
| doi_str_mv | 10.1007/s10096-020-04150-w |
| format | Article |
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All hospitalized adult patients with a diagnosis of SARS-CoV-2 infection by rRT-PCR performed on a nasopharingeal sample from March 1 to March 18 in our institution were included. The study population was divided according to the Ct value obtained upon admission in patients with high viral load (Ct < 25), intermediate viral load (Ct: 25–30) and low viral load (Ct > 30). Demographic, clinical and laboratory variables of the different groups were analyzed to assess the influence of viral load on the development of respiratory failure during admission. Overall, 455 sequential patients were included. The median Ct value was 28 (IQR: 24–32). One hundred and thirty patients (28.6%) had a high viral load, 175 (38.5%) an intermediate viral load and 150 (33%) a low viral load. Advanced age, male sex, presence of cardiovascular disease and laboratory markers such as lactate dehydrogenase, lymphocyte count and C-reactive protein, as well as a high viral load on admission, were predictive of respiratory failure. A Ct value < 25 was associated with a higher risk of respiratory failure during admission (OR: 2.99, 95%IC: 1.57–5.69). SARS-CoV-2 viral load, measured through the Ct value on admission, is a valuable tool to predict the development of respiratory failure in COVID-19 inpatients.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-020-04150-w</identifier><identifier>PMID: 33409832</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Biomedical and Life Sciences ; Biomedicine ; C-reactive protein ; Cardiovascular diseases ; Cell number ; COVID-19 ; Demographic variables ; Failure ; Infectious Diseases ; Internal Medicine ; L-Lactate dehydrogenase ; Laboratories ; Lactate dehydrogenase ; Lactic acid ; Life Sciences & Biomedicine ; Lymphocytes ; Markers ; Medical Microbiology ; Microbiology ; Original ; Original Article ; Polymerase chain reaction ; Population studies ; Respiratory failure ; RNA-directed DNA polymerase ; Science & Technology ; Severe acute respiratory syndrome coronavirus 2 ; Viral diseases</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2021-06, Vol.40 (6), p.1209-1216</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>36</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000605514100001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c474t-279093f9355ac48ec4dc7a35404c01d10f31d7eb7fa7aca1e74b9592bb44b2f43</citedby><cites>FETCH-LOGICAL-c474t-279093f9355ac48ec4dc7a35404c01d10f31d7eb7fa7aca1e74b9592bb44b2f43</cites><orcidid>0000-0002-5335-9709 ; 0000-0002-5945-5953 ; 0000-0001-5333-7529 ; 0000-0002-7317-5157 ; 0000-0003-2711-3817 ; 0000-0003-4748-8288 ; 0000-0002-5122-2039</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10096-020-04150-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10096-020-04150-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,315,782,786,887,27931,27932,39265,41495,42564,51326</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33409832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de la Calle, Cristina</creatorcontrib><creatorcontrib>Lalueza, Antonio</creatorcontrib><creatorcontrib>Mancheño-Losa, Mikel</creatorcontrib><creatorcontrib>Maestro-de la Calle, Guillermo</creatorcontrib><creatorcontrib>Lora-Tamayo, Jaime</creatorcontrib><creatorcontrib>Arrieta, Estibaliz</creatorcontrib><creatorcontrib>García-Reyne, Ana</creatorcontrib><creatorcontrib>Losada, Irene</creatorcontrib><creatorcontrib>de Miguel, Borja</creatorcontrib><creatorcontrib>Díaz-Simón, Raquel</creatorcontrib><creatorcontrib>López-Medrano, Francisco</creatorcontrib><creatorcontrib>Fernández-Ruiz, Mario</creatorcontrib><creatorcontrib>Carretero, Octavio</creatorcontrib><creatorcontrib>San Juan, Rafael</creatorcontrib><creatorcontrib>Aguado, José María</creatorcontrib><creatorcontrib>Lumbreras, Carlos</creatorcontrib><title>Impact of viral load at admission on the development of respiratory failure in hospitalized patients with SARS-CoV-2 infection</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>EUR J CLIN MICROBIOL</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>The aim of our study was to elucidate if SARS-CoV-2 viral load on admission, measured by real-time reverse transcriptase–polymerase chain reaction (rRT-PCR) cycle threshold (Ct) value on nasopharyngeal samples, was a marker of disease severity. All hospitalized adult patients with a diagnosis of SARS-CoV-2 infection by rRT-PCR performed on a nasopharingeal sample from March 1 to March 18 in our institution were included. The study population was divided according to the Ct value obtained upon admission in patients with high viral load (Ct < 25), intermediate viral load (Ct: 25–30) and low viral load (Ct > 30). Demographic, clinical and laboratory variables of the different groups were analyzed to assess the influence of viral load on the development of respiratory failure during admission. Overall, 455 sequential patients were included. The median Ct value was 28 (IQR: 24–32). One hundred and thirty patients (28.6%) had a high viral load, 175 (38.5%) an intermediate viral load and 150 (33%) a low viral load. Advanced age, male sex, presence of cardiovascular disease and laboratory markers such as lactate dehydrogenase, lymphocyte count and C-reactive protein, as well as a high viral load on admission, were predictive of respiratory failure. A Ct value < 25 was associated with a higher risk of respiratory failure during admission (OR: 2.99, 95%IC: 1.57–5.69). SARS-CoV-2 viral load, measured through the Ct value on admission, is a valuable tool to predict the development of respiratory failure in COVID-19 inpatients.</description><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>C-reactive protein</subject><subject>Cardiovascular diseases</subject><subject>Cell number</subject><subject>COVID-19</subject><subject>Demographic variables</subject><subject>Failure</subject><subject>Infectious Diseases</subject><subject>Internal Medicine</subject><subject>L-Lactate dehydrogenase</subject><subject>Laboratories</subject><subject>Lactate dehydrogenase</subject><subject>Lactic acid</subject><subject>Life Sciences & Biomedicine</subject><subject>Lymphocytes</subject><subject>Markers</subject><subject>Medical Microbiology</subject><subject>Microbiology</subject><subject>Original</subject><subject>Original Article</subject><subject>Polymerase chain reaction</subject><subject>Population 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of viral load at admission on the development of respiratory failure in hospitalized patients with SARS-CoV-2 infection</title><author>de la Calle, Cristina ; Lalueza, Antonio ; Mancheño-Losa, Mikel ; Maestro-de la Calle, Guillermo ; Lora-Tamayo, Jaime ; Arrieta, Estibaliz ; García-Reyne, Ana ; Losada, Irene ; de Miguel, Borja ; Díaz-Simón, Raquel ; López-Medrano, Francisco ; Fernández-Ruiz, Mario ; Carretero, Octavio ; San Juan, Rafael ; Aguado, José María ; Lumbreras, Carlos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-279093f9355ac48ec4dc7a35404c01d10f31d7eb7fa7aca1e74b9592bb44b2f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>C-reactive protein</topic><topic>Cardiovascular diseases</topic><topic>Cell number</topic><topic>COVID-19</topic><topic>Demographic 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journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><stitle>EUR J CLIN MICROBIOL</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>40</volume><issue>6</issue><spage>1209</spage><epage>1216</epage><pages>1209-1216</pages><issn>0934-9723</issn><eissn>1435-4373</eissn><abstract>The aim of our study was to elucidate if SARS-CoV-2 viral load on admission, measured by real-time reverse transcriptase–polymerase chain reaction (rRT-PCR) cycle threshold (Ct) value on nasopharyngeal samples, was a marker of disease severity. All hospitalized adult patients with a diagnosis of SARS-CoV-2 infection by rRT-PCR performed on a nasopharingeal sample from March 1 to March 18 in our institution were included. The study population was divided according to the Ct value obtained upon admission in patients with high viral load (Ct < 25), intermediate viral load (Ct: 25–30) and low viral load (Ct > 30). Demographic, clinical and laboratory variables of the different groups were analyzed to assess the influence of viral load on the development of respiratory failure during admission. Overall, 455 sequential patients were included. The median Ct value was 28 (IQR: 24–32). One hundred and thirty patients (28.6%) had a high viral load, 175 (38.5%) an intermediate viral load and 150 (33%) a low viral load. Advanced age, male sex, presence of cardiovascular disease and laboratory markers such as lactate dehydrogenase, lymphocyte count and C-reactive protein, as well as a high viral load on admission, were predictive of respiratory failure. A Ct value < 25 was associated with a higher risk of respiratory failure during admission (OR: 2.99, 95%IC: 1.57–5.69). 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| fulltext | fulltext |
| identifier | ISSN: 0934-9723 |
| ispartof | European journal of clinical microbiology & infectious diseases, 2021-06, Vol.40 (6), p.1209-1216 |
| issn | 0934-9723 1435-4373 |
| language | eng |
| recordid | cdi_pubmed_primary_33409832 |
| source | Springer Online Journals Complete; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | Biomedical and Life Sciences Biomedicine C-reactive protein Cardiovascular diseases Cell number COVID-19 Demographic variables Failure Infectious Diseases Internal Medicine L-Lactate dehydrogenase Laboratories Lactate dehydrogenase Lactic acid Life Sciences & Biomedicine Lymphocytes Markers Medical Microbiology Microbiology Original Original Article Polymerase chain reaction Population studies Respiratory failure RNA-directed DNA polymerase Science & Technology Severe acute respiratory syndrome coronavirus 2 Viral diseases |
| title | Impact of viral load at admission on the development of respiratory failure in hospitalized patients with SARS-CoV-2 infection |
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