High SARS-CoV-2 viral load is associated with a worse clinical outcome of COVID-19 disease

  1. María Eugenia Soria
  2. Marta Cortón
  3. Brenda Martínez-González
  4. Rebeca Lobo-Vega
  5. Lucía Vázquez-Sirvent
  6. Rosario López-Rodríguez
  7. Berta Almoguera
  8. Ignacio Mahillo
  9. Pablo Mínguez
  10. Antonio Herrero
  11. Juan Carlos Taracido
  12. Alicia Macías-Valcayo
  13. Jaime Esteban
  14. Ricardo Fernandez-Roblas
  15. Ignacio Gadea
  16. Javier Ruíz-Hornillos
  17. Carmen Ayuso
  18. Celia Perales

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Abstract

COVID-19 severity and progression are determined by several host and virological factors that may influence the final outcome of SARS-CoV-2-infected patients. The objective of this work was to determine a possible association between viral load, obtained from nasopharyngeal swabs, and the severity of the infection in a cohort of 448 SARS-CoV-2-infected patients from a hospital in Madrid during the first outbreak of the pandemic in Spain. To perform this, we clinically classified patients as mild, moderate and severe COVID-19 according to a number of clinical parameters such as hospitalization requirement, need of oxygen therapy, admission to intensive care units and/or death. Also, Ct values were determined using SARS-CoV-2-specific oligonucleotides directed to ORF1ab. Here we report a statistically significant association between viral load and disease severity, a high viral load being associated with worse clinical prognosis, independently of several previously identified risk factors such as age, sex, hypertension, cardiovascular disease, diabetes, obesity and lung disease (asthma and chronic obstructive pulmonary disease). The data presented here reinforce viral load as a potential biomarker for predicting disease severity in SARS-CoV-2-infected patients. It is also an important parameter in viral evolution since it relates to the numbers and types of variant genomes present in a viral population, a potential determinant of disease progression.

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  1. Version published to 10.1099/acmi.0.000259 on Access Microbiology
  2. ScreenIT

    SciScore for 10.1101/2020.11.13.20229666: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the Ethics Committee and the Institutional Review Board of the FJD hospital (no. PIC-087-20-FJD).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistics: The statistically significance of differences among viral load values according to the infection severity was calculated with the ANOVA test and t-test with Bonferroni correction using GraphPad Prism 7.00.
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04505709Enrolling by invitationClinical, Immunological, Genomic, Virological and Bioethical…

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.11.13.20229666 on medRxiv