Impact of SARS-CoV-2 viral load and duration of symptoms before hospital admission on the mortality of hospitalized COVID-19 patients

Purpose Assess the impact of viral load estimated by cycle threshold (Ct) of reverse transcription real time-polymerase chain reaction (rRT-PCR) and the days from symptoms onset on mortality in hospitalized patients with COVID19. Methods Retrospective observational study of 782 patients with a posit...

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Bibliographic Details
Published in:Infection 2022-10, Vol.50 (5), p.1321-1328
Main Authors: Rico-Caballero, Verónica, Fernández, Mariana, Hurtado, Juan C., Marcos, M. Angeles, Cardozo, Celia, Albiach, Laia, Agüero, Daiana, Ambrosioni, Juan, Bodro, Marta, Chumbita, Mariana, De la Mora, Lorena, Garcia-Pouton, Nicole, Gonzalez-Cordón, Ana, Dueñas, Gerard, Hernandez-Meneses, Marta, Inciarte, Alexy, Laguno, Montse, Leal, Lorna, Macaya, Irene, Martínez, Miguel J., Cuesta, Genoveva, Meira, Fernanda, Morata, Laura, Puerta-Alcalde, Pedro, Rojas, John, Torres, Berta, Castro, Pedro, Muñoz, Jose, Mensa, Josep, Martínez, José Antonio, Sanjuan, Gemma, Vila, Jordi, García, Felipe, Garcia-Vidal, Carolina, Soriano, Alex
Format: Article
Language:English
Subjects:
Antiviral agents
Antiviral drugs
COVID-19
Family Medicine
General Practice
Hospitalization
Infectious Diseases
Internal Medicine
Medicine
Medicine & Public Health
Mortality
Multivariate analysis
Original Paper
Parameter identification
Patients
Polymerase chain reaction
Reverse transcription
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Viral diseases
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Summary:Purpose Assess the impact of viral load estimated by cycle threshold (Ct) of reverse transcription real time-polymerase chain reaction (rRT-PCR) and the days from symptoms onset on mortality in hospitalized patients with COVID19. Methods Retrospective observational study of 782 patients with a positive rRT-PCR from a nasopharyngeal swab was performed within the first 24 h from admission. Demographic data, clinical manifestations and laboratory parameters were collected. Uni- and multivariate analyses were performed to identify factors associated with mortality at 60 days. Results Ct was divided into three groups and the mortality rate decreased from 27.3 to 20.7% and 9.8% for Ct values of ≤ 20, 21–25 and > 25, respectively ( P  = 0.0001). The multivariate analysis identified as predictors of mortality, a Ct value  25. Days from symptoms onset is a variable associated with mortality as well (DSOA) ≤ 6 (OR 1.86, CI 95% 1.00–3.46), among other factors. Patients requiring hospital admission within 6 DSOA with a Ct value ≤ 25 had the highest mortality rate (28%). Conclusions The inclusion of Ct values and DSOA in the characterization of study populations could be a useful tool to evaluate the efficacy of antivirals.
ISSN:0300-8126
1439-0973
1439-0973
DOI:10.1007/s15010-022-01833-8