Correlation of SARS-CoV-2 Nasopharyngeal CT Values With Viremia and Mortality in Adults Hospitalized With COVID-19.

COVID-19 RNAemia SARS-CoV-2 viral load viremia

Journal

Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 17 05 2022
accepted: 08 09 2022
entrez: 3 10 2022
pubmed: 4 10 2022
medline: 4 10 2022
Statut: epublish

Résumé

Both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viremia and nasopharyngeal viral load have been suggested to be predictors of unfavorable outcome in coronavirus disease 2019 (COVID-19). This study aimed to investigate whether nasopharyngeal viral load is correlated with viremia and unfavorable outcome. The presence of SARS-CoV-2 RNA was determined in paired nasopharyngeal and serum samples collected at admission from patients hospitalized for COVID-19. Standardized cycle threshold values (CT values) were used as an indicator of viral load. An adjusted logistic regression was used to estimate the risk of viremia at different nasopharyngeal CT values. A Cox regression was used to estimate the risk of 60-day mortality. A total of 688 patients were included. Viremia at admission was detected in 63% (146/230), 46% (105/226), and 31% (73/232) of patients with low, intermediate, and high nasopharyngeal CT values. The adjusted odds ratios of being viremic were 4.4 (95% CI, 2.9-6.8) and 2.0 (95% CI, 1.4-3.0) for patients with low and intermediate CT values, compared with high CT values. The 60-day mortality rate was 37% (84/230), 15% (36/226), and 10% (23/232) for patients with low, intermediate, and high nasopharyngeal CT values at admission, respectively. Adjusted hazard ratios were 2.6 (95% CI, 1.6-4.2) and 1.4 (95% CI, 0.8-2.4) for patients with low and intermediate CT values compared with high CT values. There was a dose-dependent correlation between nasopharyngeal CT values and viremia at admission for COVID-19. Moreover, there was an increased risk of 60-day mortality for patients with low, compared with high, nasopharyngeal CT values.

Sections du résumé

Background UNASSIGNED
Both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viremia and nasopharyngeal viral load have been suggested to be predictors of unfavorable outcome in coronavirus disease 2019 (COVID-19). This study aimed to investigate whether nasopharyngeal viral load is correlated with viremia and unfavorable outcome.
Methods UNASSIGNED
The presence of SARS-CoV-2 RNA was determined in paired nasopharyngeal and serum samples collected at admission from patients hospitalized for COVID-19. Standardized cycle threshold values (CT values) were used as an indicator of viral load. An adjusted logistic regression was used to estimate the risk of viremia at different nasopharyngeal CT values. A Cox regression was used to estimate the risk of 60-day mortality.
Results UNASSIGNED
A total of 688 patients were included. Viremia at admission was detected in 63% (146/230), 46% (105/226), and 31% (73/232) of patients with low, intermediate, and high nasopharyngeal CT values. The adjusted odds ratios of being viremic were 4.4 (95% CI, 2.9-6.8) and 2.0 (95% CI, 1.4-3.0) for patients with low and intermediate CT values, compared with high CT values. The 60-day mortality rate was 37% (84/230), 15% (36/226), and 10% (23/232) for patients with low, intermediate, and high nasopharyngeal CT values at admission, respectively. Adjusted hazard ratios were 2.6 (95% CI, 1.6-4.2) and 1.4 (95% CI, 0.8-2.4) for patients with low and intermediate CT values compared with high CT values.
Conclusions UNASSIGNED
There was a dose-dependent correlation between nasopharyngeal CT values and viremia at admission for COVID-19. Moreover, there was an increased risk of 60-day mortality for patients with low, compared with high, nasopharyngeal CT values.

Identifiants

pubmed: 36185351
doi: 10.1093/ofid/ofac463
pii: ofac463
pmc: PMC9518228
doi:

Types de publication

Journal Article

Langues

eng

Pagination

ofac463

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Références

Neurology. 2021 Jan 12;96(2):e294-e300
pubmed: 33004602
BMC Infect Dis. 2021 Feb 17;21(1):184
pubmed: 33596855
J Infect. 2021 Mar;82(3):e38-e41
pubmed: 33248220
Clin Infect Dis. 2021 Aug 2;73(3):e799-e802
pubmed: 32888003
Blood. 2020 Nov 12;136(20):2290-2295
pubmed: 32959052
Nat Rev Immunol. 2021 Apr;21(4):245-256
pubmed: 33723416
Science. 2021 Jul 9;373(6551):
pubmed: 34035154
JAMA Oncol. 2021 Jun 17;:
pubmed: 34137799
Clin Infect Dis. 2021 Dec 6;73(11):e4197-e4205
pubmed: 32603425
Acad Emerg Med. 2021 Mar;28(3):306-313
pubmed: 33481307
Diagn Microbiol Infect Dis. 2022 Mar;102(3):115595
pubmed: 34896666
Crit Care. 2020 Dec 14;24(1):691
pubmed: 33317616
Clin Infect Dis. 2021 Nov 2;73(9):e2995-e3001
pubmed: 32856036
J Clin Invest. 2021 Jul 1;131(13):
pubmed: 34196300
Lancet Respir Med. 2020 Sep;8(9):e70
pubmed: 32771081
J Infect Dis. 2022 May 02;:
pubmed: 35511031
Nat Commun. 2021 Nov 16;12(1):6612
pubmed: 34785663
mSphere. 2021 Jun 30;6(3):e0031121
pubmed: 34047654
Clin Infect Dis. 2022 Jan 29;74(2):218-226
pubmed: 33949665
Clin Microbiol Infect. 2021 Jun;27(6):886-891
pubmed: 33631334
Clin Infect Dis. 2022 May 3;74(9):1525-1533
pubmed: 34374761
Proc Natl Acad Sci U S A. 2021 May 25;118(21):
pubmed: 33972412
Open Forum Infect Dis. 2021 Jan 04;8(2):ofab003
pubmed: 33604401

Auteurs

Karl Hagman (K)

Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.

Magnus Hedenstierna (M)

Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden.

Jacob Widaeus (J)

Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden.

Emelie Arvidsson (E)

Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden.

Berit Hammas (B)

Department of Clinical Microbiology, Karolinska University Hospital, StockholmSweden.

Lena Grillner (L)

Department of Clinical Microbiology, Karolinska University Hospital, StockholmSweden.

Jan Jakobsson (J)

Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Department of Anaesthesia and Intensive Care, Danderyd Hospital, Stockholm, Sweden.

Patrik Gille-Johnson (P)

Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden.

Johan Ursing (J)

Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden.

Classifications MeSH