• Jesse Fajnzylber, James Regan, Kendyll Coxen, Heather Corry, Colline Wong, Alexandra Rosenthal, Daniel Worrall, Francoise Giguel, Alicja Piechocka-Trocha, Caroline Atyeo, Stephanie Fischinger, Andrew Chan, Keith T Flaherty, Kathryn Hall, Michael Dougan, Edward T Ryan, Elizabeth Gillespie, Rida Chishti, Yijia Li, Nikolaus Jilg, Dusan Hanidziar, Rebecca M Baron, Lindsey Baden, Athe M Tsibris, Katrina A Armstrong, Daniel R Kuritzkes, Galit Alter, Bruce D Walker, Xu Yu, Jonathan Z Li, and Massachusetts Consortium for Pathogen Readiness.
• Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
• Nat Commun. 2020 Oct 30; 11 (1): 5493.

AbstractThe relationship between SARS-CoV-2 viral load and risk of disease progression remains largely undefined in coronavirus disease 2019 (COVID-19). Here, we quantify SARS-CoV-2 viral load from participants with a diverse range of COVID-19 disease severity, including those requiring hospitalization, outpatients with mild disease, and individuals with resolved infection. We detected SARS-CoV-2 plasma RNA in 27% of hospitalized participants, and 13% of outpatients diagnosed with COVID-19. Amongst the participants hospitalized with COVID-19, we report that a higher prevalence of detectable SARS-CoV-2 plasma viral load is associated with worse respiratory disease severity, lower absolute lymphocyte counts, and increased markers of inflammation, including C-reactive protein and IL-6. SARS-CoV-2 viral loads, especially plasma viremia, are associated with increased risk of mortality. Our data show that SARS-CoV-2 viral loads may aid in the risk stratification of patients with COVID-19, and therefore its role in disease pathogenesis should be further explored.

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