Upper respiratory tract viral load could identify high-risk patients with COVID-19
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Upper respiratory tract viral load could be used to identify patients with COVID-19 who are at higher risk for severe outcomes, according to findings from a study conducted in Greece.
“Our aim was to identify factors associated with severe morbidity — defined as admission to ICU or intubation — or fatal outcome in order to assist physicians and health care researchers on decisions at the time of diagnosis,” Helena C. Maltezou, MD, PhD, DU, an infectious disease specialist at the Hellenic National Public Health Organization in Athens, told Healio. “In addition, we aimed to study the association between comorbidities and viral loads in SARS-CoV-2-infected patients.”
Maltezou and colleagues assessed 1,122 patients who were diagnosed by PCR between Feb. 26 through May 3 the first epidemic wave of COVID-19 in Greece. According to the study, upper respiratory tract (URT) viral load, measured by PCR cycle threshold, was categorized as high, moderate or low for the sake of the study.
Of all the included patients, 309 (27.5%) had high viral loads, 316 (28.2%) moderate and 497 (44.3%) low. According to the study, there were 336 (29.9%) patients with comorbidities. Patients with chronic cardiovascular disease, hypertension, chronic pulmonary disease, immunosuppression, obesity and chronic neurological disease more often had a high viral load (P < .05).
An analysis showed that, compared with patients with moderate or low URT viral load, patients with high URT viral load were more likely to develop COVID-19 (P < 0.001) be intubated (P = 0.05), and die (P= 0.03), the researchers reported. Additionally, patients with high viral load had longer stays in the ICU and longer intubation periods compared with patients with a low viral load (P < .05).
“The take-home message is that viral loads — categorized as high, moderate or low based on Ct values — can be used to identify patients at higher risk for morbidity or severe outcome,” Maltezou said.
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