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

2021; Nature Portfolio; Volume: 11; Issue: 1 Linguagem: Inglês

10.1038/s41598-021-92400-y

2045-2322

Sonsoles Salto‐Alejandre, Judith Berastegui‐Cabrera, Pedro Camacho‐Martínez, Carmen Infante-Domínguez, Marta Carretero-Ledesma, Juan Carlos Crespo‐Rivas, Eduardo Márquez Martín, José Manuel Lomas, Claudio Bueno, Rosario Amaya, José Antonio Lepe, José Miguel Cisneros, Jerónimo Pachón, Elisa Cordero, Javier Sánchez‐Céspedes, José Miguel Cisneros, Manuela Aguilar‐Guisado, Almudena Aguilera, Clara Aguilera, T. Aldabó-Pallás, Verónica Alfaro‐Lara, Cristina Amodeo, Javier Ampuero, María Dolores Avilés, Maribel Asensio, Bosco Barón‐Franco, L. Barrera Pulido, Rafael Bellido-Alba, Máximo Bernabéu-Wittel, Candela Caballero‐Eraso, Macarena Cabrera‐Serrano, Enrique J. Calderón, J. Carbajal-Guerrero, Manuela Cid-Cumplido, Y. Corcia-Palomo, Juan Delgado, Antonio Domínguez-Petit, Alejandro Deniz, Reginal Dusseck-Brutus, Ana Escoresca‐Ortega, Núria Espinosa, Núria Espinosa, Michelle Espinoza, Carmen Ferrándiz‐Millón, Marta Ferrer‐García, Teresa Ferrer, Ignacio Gallego-Texeira, Rosa Gámez-Mancera, Emilio Gutiérrez, Horacio García-Delgado, Manuel García‐Gutiérrez, María Luisa Gascón-Castillo, Aurora González-Estrada, Demetrio González, Carmen Gómez-González, Rocío González-León, Carmen Grande-Cabrerizo, Sonia Celedonia Huyhua Gutiérrez, Carlos Hernández-Quiles, Inmaculada Concepción Herrera-Melero, Marta Herrero, Luis Jara‐Palomares, Carlos Jiménez-Juan, Silvia Jiménez‐Jorge, Mercedes Jiménez-Sánchez, Julia Lanseros-Tenllado, Carmina López, Isabel López, Álvaro López-Barrios, Luís F. López‐Cortés, Rafael Luque‐Márquez, Daniel Macías‐García, Guillermo Martín-Gutiérrez, Luis Martín-Villén, José Molina, Aurora Fernández‐Cañadas Morillo, María Dolores Navarro-Amuedo, Dolores Nieto-Martín, Francisco Órtega Ruiz, María Paniagua‐García, Amelia Peña-Rodríguez, Esther Pérez‐Herrán, Manuel Poyato Borrego, Julia Praena‐Segovia, Rafaela Ríos, Cristina Roca-Oporto, Jesús Flores Rodríguez, María Jesús Rodríguez-Hernández, Santiago Rodríguez-Suárez, Ángel Rodríguez-Villodres, Nieves Romero-Rodríguez, Ricardo Ruiz, Zaida Ruiz de Azua, Celia Salamanca, Sonia Sánchez, Víctor Manuel Sánchez-Montagut, César Sotomayor, A. Suarez, Javier Toral,

COVID-19 Clinical Research Studies

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 log 10 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 log 10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log 10 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, SpO 2 , neutrophils > 7.5 × 10 3 /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.