SARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.

<h4>Introduction</h4>We aimed to examine if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) cycle quantification (Cq) value, as a surrogate for SARS-CoV-2 viral load, could predict hospitalisation and disease severity in adult patients with co...

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Autores principales:	Fredrikke Christie Knudtzen, Thøger Gorm Jensen, Susan Olaf Lindvig, Line Dahlerup Rasmussen, Lone Wulff Madsen, Silje Vermedal Hoegh, Malene Bek-Thomsen, Christian B Laursen, Stig Lønberg Nielsen, Isik Somuncu Johansen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2f65649d8c23469fb8437f88222af1d5
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spelling	oai:doaj.org-article:2f65649d8c23469fb8437f88222af1d52021-11-25T06:18:59ZSARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.1932-620310.1371/journal.pone.0258421https://doaj.org/article/2f65649d8c23469fb8437f88222af1d52021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258421https://doaj.org/toc/1932-6203<h4>Introduction</h4>We aimed to examine if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) cycle quantification (Cq) value, as a surrogate for SARS-CoV-2 viral load, could predict hospitalisation and disease severity in adult patients with coronavirus disease 2019 (COVID-19).<h4>Methods</h4>We performed a prospective cohort study of adult patients with PCR positive SARS-CoV-2 airway samples including all out-patients registered at the Department of Infectious Diseases, Odense University Hospital (OUH) March 9-March 17 2020, and all hospitalised patients at OUH March 10-April 21 2020. To identify associations between Cq-values and a) hospital admission and b) a severe outcome, logistic regression analyses were used to compute odds ratios (OR) and 95% Confidence Intervals (CI), adjusting for confounding factors (aOR).<h4>Results</h4>We included 87 non-hospitalised and 82 hospitalised patients. The median baseline Cq-value was 25.5 (interquartile range 22.3-29.0). We found a significant association between increasing Cq-value and hospital-admission in univariate analysis (OR 1.11, 95% CI 1.04-1.19). However, this was due to an association between time from symptom onset to testing and Cq-values, and no association was found in the adjusted analysis (aOR 1.08, 95% CI 0.94-1.23). In hospitalised patients, a significant association between lower Cq-values and higher risk of severe disease was found (aOR 0.89, 95% CI 0.81-0.98), independent of timing of testing.<h4>Conclusions</h4>SARS-CoV-2 PCR Cq-values in outpatients correlated with time after symptom onset, but was not a predictor of hospitalisation. However, in hospitalised patients lower Cq-values were associated with higher risk of severe disease.Fredrikke Christie KnudtzenThøger Gorm JensenSusan Olaf LindvigLine Dahlerup RasmussenLone Wulff MadsenSilje Vermedal HoeghMalene Bek-ThomsenChristian B LaursenStig Lønberg NielsenIsik Somuncu JohansenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258421 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Fredrikke Christie Knudtzen Thøger Gorm Jensen Susan Olaf Lindvig Line Dahlerup Rasmussen Lone Wulff Madsen Silje Vermedal Hoegh Malene Bek-Thomsen Christian B Laursen Stig Lønberg Nielsen Isik Somuncu Johansen SARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.
description	<h4>Introduction</h4>We aimed to examine if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) cycle quantification (Cq) value, as a surrogate for SARS-CoV-2 viral load, could predict hospitalisation and disease severity in adult patients with coronavirus disease 2019 (COVID-19).<h4>Methods</h4>We performed a prospective cohort study of adult patients with PCR positive SARS-CoV-2 airway samples including all out-patients registered at the Department of Infectious Diseases, Odense University Hospital (OUH) March 9-March 17 2020, and all hospitalised patients at OUH March 10-April 21 2020. To identify associations between Cq-values and a) hospital admission and b) a severe outcome, logistic regression analyses were used to compute odds ratios (OR) and 95% Confidence Intervals (CI), adjusting for confounding factors (aOR).<h4>Results</h4>We included 87 non-hospitalised and 82 hospitalised patients. The median baseline Cq-value was 25.5 (interquartile range 22.3-29.0). We found a significant association between increasing Cq-value and hospital-admission in univariate analysis (OR 1.11, 95% CI 1.04-1.19). However, this was due to an association between time from symptom onset to testing and Cq-values, and no association was found in the adjusted analysis (aOR 1.08, 95% CI 0.94-1.23). In hospitalised patients, a significant association between lower Cq-values and higher risk of severe disease was found (aOR 0.89, 95% CI 0.81-0.98), independent of timing of testing.<h4>Conclusions</h4>SARS-CoV-2 PCR Cq-values in outpatients correlated with time after symptom onset, but was not a predictor of hospitalisation. However, in hospitalised patients lower Cq-values were associated with higher risk of severe disease.
format	article
author	Fredrikke Christie Knudtzen Thøger Gorm Jensen Susan Olaf Lindvig Line Dahlerup Rasmussen Lone Wulff Madsen Silje Vermedal Hoegh Malene Bek-Thomsen Christian B Laursen Stig Lønberg Nielsen Isik Somuncu Johansen
author_facet	Fredrikke Christie Knudtzen Thøger Gorm Jensen Susan Olaf Lindvig Line Dahlerup Rasmussen Lone Wulff Madsen Silje Vermedal Hoegh Malene Bek-Thomsen Christian B Laursen Stig Lønberg Nielsen Isik Somuncu Johansen
author_sort	Fredrikke Christie Knudtzen
title	SARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.
title_short	SARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.
title_full	SARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.
title_fullStr	SARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.
title_full_unstemmed	SARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.
title_sort	sars-cov-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with covid-19: a prospective cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2f65649d8c23469fb8437f88222af1d5
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SARS-CoV-2 viral load as a predictor for disease severity in outpatients and hospitalised patients with COVID-19: A prospective cohort study.

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