• Niccolò Buetti, Paul-Henri Wicky, Quentin Le Hingrat, Stéphane Ruckly, Timothy Mazzuchelli, Ambre Loiodice, Pierpaolo Trimboli, Valentina Forni Ogna, Etienne de Montmollin, Enos Bernasconi, Benoit Visseaux, and Jean-François Timsit.
• University of Paris, INSERM, IAME, F-75006, Paris, France. niccolo.buetti@gmail.com.
• Crit Care. 2020 Oct 16; 24 (1): 610.

BackgroundData on SARS-CoV-2 load in lower respiratory tract (LRT) are scarce. Our objectives were to describe the viral shedding and the viral load in LRT and to determine their association with mortality in critically ill COVID-19 patients.MethodsWe conducted a binational study merging prospectively collected data from two COVID-19 reference centers in France and Switzerland. First, we described the viral shedding duration (i.e., time to negativity) in LRT samples. Second, we analyzed viral load in LRT samples. Third, we assessed the association between viral presence in LRT and mortality using mixed-effect logistic models for clustered data adjusting for the time between symptoms' onset and date of sampling.ResultsFrom March to May 2020, 267 LRT samples were performed in 90 patients from both centers. The median time to negativity was 29 (IQR 23; 34) days. Prolonged viral shedding was not associated with age, gender, cardiac comorbidities, diabetes, immunosuppression, corticosteroids use, or antiviral therapy. The LRT viral load tended to be higher in non-survivors. This difference was statistically significant after adjusting for the time interval between onset of symptoms and date of sampling (OR 3.78, 95% CI 1.13-12.64, p = 0.03).ConclusionsThe viral shedding in LRT lasted almost 30 days in median in critically ill patients, and the viral load in the LRT was associated with the 6-week mortality.

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