SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

Abstract 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...

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Autores principales:	Sonsoles Salto-Alejandre, Judith Berastegui-Cabrera, Pedro Camacho-Martínez, Carmen Infante-Domínguez, Marta Carretero-Ledesma, Juan Carlos Crespo-Rivas, Eduardo Márquez, José Manuel Lomas, Claudio Bueno, Rosario Amaya, José Antonio Lepe, José Miguel Cisneros, Jerónimo Pachón, Elisa Cordero, Javier Sánchez-Céspedes, The Virgen del Rocío Hospital COVID-19 Working Team
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/52a0eda628644dde8b6c851c2d954265
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spelling	oai:doaj.org-article:52a0eda628644dde8b6c851c2d9542652021-12-02T17:14:24ZSARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome10.1038/s41598-021-92400-y2045-2322https://doaj.org/article/52a0eda628644dde8b6c851c2d9542652021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92400-yhttps://doaj.org/toc/2045-2322Abstract 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.Sonsoles Salto-AlejandreJudith Berastegui-CabreraPedro Camacho-MartínezCarmen Infante-DomínguezMarta Carretero-LedesmaJuan Carlos Crespo-RivasEduardo MárquezJosé Manuel LomasClaudio BuenoRosario AmayaJosé Antonio LepeJosé Miguel CisnerosJerónimo PachónElisa CorderoJavier Sánchez-CéspedesThe Virgen del Rocío Hospital COVID-19 Working TeamNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-Rivas Eduardo Márquez José Manuel Lomas Claudio Bueno Rosario Amaya José Antonio Lepe José Miguel Cisneros Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes The Virgen del Rocío Hospital COVID-19 Working Team SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome
description	Abstract 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.
format	article
author	Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-Rivas Eduardo Márquez José Manuel Lomas Claudio Bueno Rosario Amaya José Antonio Lepe José Miguel Cisneros Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes The Virgen del Rocío Hospital COVID-19 Working Team
author_facet	Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-Rivas Eduardo Márquez José Manuel Lomas Claudio Bueno Rosario Amaya José Antonio Lepe José Miguel Cisneros Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes The Virgen del Rocío Hospital COVID-19 Working Team
author_sort	Sonsoles Salto-Alejandre
title	SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome
title_short	SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome
title_full	SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome
title_fullStr	SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome
title_full_unstemmed	SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome
title_sort	sars-cov-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/52a0eda628644dde8b6c851c2d954265
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SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

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