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Volume 3, Issue 9

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

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.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): COVID-19 , risk factors and viral load
Funding
This study was supported by the:
  • Comunidad de Madrid (Award PEJD-2019-PRE/BMD-16414)
    • Principal Award Recipient: RebecaLobo-Vega
  • Instituto de Salud Carlos III (Award PFIS FI19/00119)
    • Principal Award Recipient: BrendaMartínez-González
  • Instituto de Salud Carlos III (Award CP16/00116)
    • Principal Award Recipient: PabloMínguez
  • Instituto de Salud Carlos III (Award CPII17/00006)
    • Principal Award Recipient: MartaCortón
  • Instituto de Salud Carlos III (Award CPII19/00001)
    • Principal Award Recipient: CeliaPerales
  • Instituto de Salud Carlos III (Award PI18/00210)
    • Principal Award Recipient: CeliaPerales
  • Ministerio de Ciencia, Innovación y Universidades (Award BFU2017-91384-EXP)
    • Principal Award Recipient: CeliaPerales
  • Consejo Superior de Investigaciones Científicas (Award CSIC-COV19-014)
    • Principal Award Recipient: CeliaPerales
  • Instituto de Salud Carlos III (Award COV20/00181)
    • Principal Award Recipient: CarmenAyuso
© 2021 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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2021-09-21
2025-12-09

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High SARS-CoV-2 viral load is associated with a worse clinical outcome of COVID-19 disease
Access Microbiology 3, 000259 (2021); https://doi.org/10.1099/acmi.0.000259
/content/journal/acmi/10.1099/acmi.0.000259
/content/journal/acmi/10.1099/acmi.0.000259
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