Department of Internal Medicine, Hospital Universitario ''12 de Octubre'', Instituto de Investigación Sanitaria Hospital ''12 de Octubre'' (imas12), Madrid, Spain.
Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
Eur J Clin Microbiol Infect Dis. 2021 Jun;40(6):1209-1216. doi: 10.1007/s10096-020-04150-w. Epub 2021 Jan 7.
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.
我们的研究目的是阐明入院时通过实时逆转录-聚合酶链反应（rRT-PCR）循环阈值（Ct）值测量的 SARS-CoV-2 病毒载量是否是疾病严重程度的标志物。所有在我们机构进行的鼻咽样本 rRT-PCR 检测确诊 SARS-CoV-2 感染的住院成年患者均被纳入本研究。根据入院时获得的 Ct 值，将研究人群分为高病毒载量组（Ct<25）、中病毒载量组（Ct：25-30）和低病毒载量组（Ct>30）。分析不同组别的人口统计学、临床和实验室变量，以评估病毒载量对入院期间呼吸衰竭发展的影响。共有 455 例连续患者被纳入本研究。中位 Ct 值为 28（IQR：24-32）。130 例患者（28.6%）病毒载量高，175 例（38.5%）病毒载量中等，150 例（33%）病毒载量低。高龄、男性、存在心血管疾病以及乳酸脱氢酶、淋巴细胞计数和 C 反应蛋白等实验室标志物，以及入院时病毒载量高，均预测会发生呼吸衰竭。入院时 Ct 值<25 与入院期间发生呼吸衰竭的风险增加相关（OR：2.99，95%CI：1.57-5.69）。入院时通过 Ct 值测量的 SARS-CoV-2 病毒载量是预测 COVID-19 住院患者呼吸衰竭发展的有价值工具。
