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Levels of viral genetic material, or viral load, detected in COVID-19 patients at the time of admission may be a predictor of poor outcomes “beyond age, other medical problems, and disease severity at presentation “according to a new study that says the measure can be used to stratify the risk of those infected with the new coronavirus.
Researchers, including those from Langone Health at New York University (NYU) in the US, analyzed the medical records of 314 patients who came to the emergency room between March 31 and April 10, 2020, diagnosed with COVID-19 in a molecular diagnosis. (RT-PCR), who also had viral pneumonia severe enough to require hospitalization.
In the study, published in the Annals of the American Thoracic Society, they examined whether the amount of RNA, or genomic load, of the coronavirus detected in smear tests of patients admitted to hospital with viral pneumonia is associated with more severe COVID. . 19.
“We show that for patients admitted to hospital with COVID-19 pneumonia, the burden of SARS-CoV-2, as reflected in the CRP cycle threshold (Ct) value, should be considered as a predictor of adverse outcomes, “said study co-author Ioannis M. Zacharioudakis from New York University.
The scientists explained that the cycle threshold Ct value is one of the results that the PCR technique gives that can be used as a surrogate for the amount of virus that is detected in nasopharyngeal swabs.
“A high viral load has been shown to be a predictor of unfavorable outcomes beyond age, other medical problems, and disease severity at presentation, indicating that it can be used to stratify risk or classify patients.” Zacharioudakis said.
According to the researchers, RT-PCR tests for SARS-CoV-2 are the most accurate class of COVID-19 tests available and can sample and analyze the greatest amount of genetic material, even in the presymptomatic stages of the disease.
In the current study, they collected respiratory samples from patients that were analyzed by RT-PCR technology using nasopharyngeal swabs.
Research endpoints included whether a patient required mechanical ventilation and whether the patient died while in hospital or was discharged from hospice.
“We know that the virus multiplies rapidly in the asymptomatic and early symptomatic stages of COVID-19,” Zacharioudakis noted.
“Our study is in line with this conclusion, as indicated by our finding of a higher viral load in patients with earlier disease,” he added.
The study also found that patients who had multiple comorbid conditions, such as heart disease, diabetes, and cancer, were more likely to have a higher SARS-CoV-2 burden at hospitalization and, as a result, a higher risk of poor outcomes. .
According to the scientists, the association of high viral load with poor patient outcomes was maintained after taking into account the patients’ underlying conditions, how long they were ill before arriving at the hospital, and how ill they were at the time they were presented.
Among patients with a severe clinical presentation, researchers believe that those with a high viral load were nearly twice as likely to be intubated or die.
“Our study provides a rationale for using patients’ SARS-CoV-2 burden at the time of hospital admission to assess their risk of adverse outcomes,” added Zacharioudakis.
“In an era where the availability of antiviral drugs that have been shown to be effective against COVID-19 could be limited and the capacity for intensive monitoring is finite, it is of utmost importance to be able to prioritize patients who will benefit the most from early or early treatment. a higher level of care, “he added.
Scientists believe that more studies are needed to assess whether a decrease in the viral load of hospitalized COVID-19 patients, who may or may not be treated with antiviral drugs, is related to an improvement in clinical status.
Image-AP
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