SARS-CoV-2 viral load in sputum correlates with risk of COVID-19 progression

X, Yu; Sun, Shanshan; Shi, Yu; Wang, Hao; Zhao, Ruihong; Sheng, Jifang

doi:10.1186/s13054-020-02893-8

Cited by 174 publications

(206 citation statements)

References 4 publications

Supporting

Mentioning

187

Contrasting

Unclassified

Order By: Relevance

“…One study reported that SARS-CoV-2 Ct values at hospital admission negatively correlated with the probability of progression to severe disease in 62 patients who presented with mild-moderate disease (Table 1). 17 Lower Ct values were observed in specimens from patients who became severely ill during hospitalisation than those who did not (24 vs. 29; p = 0.008).…”

Section: Disease Progressionmentioning

confidence: 90%

“…The PRISMA owchart of included studies is shown in Figure 1. Data from 18 studies were relevant for inclusion and are summarised in Tables 1 and 2. Twelve studies (63%) were conducted in China or Hong Kong, [10][11][12][13][14][15][16][17][18][19][20][21] three studies were performed in Europe [22][23][24] and three studies were carried out in the USA or Canada. [25][26][27] Nearly all studies reported data for specimens from the respiratory tract, although two studies analysed saliva, 21,22 one used stool and serum samples in addition to respiratory samples, 19 and one used both throat and anal swabs.…”

Section: Included Studiesmentioning

confidence: 99%

“…Six studies analysed SARS-CoV-2 Ct values at multiple time points for each patient, 10,11,[18][19][20][21] and seven studies determined Ct values at hospital admission or diagnosis. [12][13][14][15][16][17]22 Fourteen studies reported on the direct correlation of outcomes with Ct values. [10][11][12][13][14]16,17,20,[22][23][24][25][26][27] Three studies reported on the correlation of outcomes with viral load, determined using standard curves of Ct values versus RNA copy number, 15,19,21 and one study correlated outcomes with the inverse of Ct values, taken as a proxy for viral load.…”

Section: Included Studiesmentioning

confidence: 99%

“…Eleven studies (with numbers of PCR-positive patients ranging from 10 to 308) reported on the correlation between Ct value and disease severity, [10][11][12][13][14]16,17,20,23,25,26 ower Ct values from respiratory samples were associated with more severe disease in 7 (64%) of these ( Table 2). [11][12][13][14]16,17,23 Three studies (with numbers of PCR-positive patients ranging from 23 to 114) reported on the correlation between viral load determined via Ct values and disease severity 15,19,21 and one of these (which included 96 patients) reported that higher viral loads were signi cantly associated with more severe disease ( Table 2). 19 Of the 15 studies reporting on the correlation between Ct value or viral load determined via Ct value and disease severity, 11 were performed in hospitalised patients [10][11][12][13][14][15][16][17]19,21,23 and three included non-hospitalised patients.…”

Section: Disease Severitymentioning

confidence: 99%

“…[11][12][13][14]16,17,23 Three studies (with numbers of PCR-positive patients ranging from 23 to 114) reported on the correlation between viral load determined via Ct values and disease severity 15,19,21 and one of these (which included 96 patients) reported that higher viral loads were signi cantly associated with more severe disease ( Table 2). 19 Of the 15 studies reporting on the correlation between Ct value or viral load determined via Ct value and disease severity, 11 were performed in hospitalised patients [10][11][12][13][14][15][16][17]19,21,23 and three included non-hospitalised patients. 20,25,26 Of the eleven studies performed in hospitalised patients only, eight (73%) reported an association between Ct value and disease severity, [11][12][13][14]16,17,19,23 of which six showed statistical signi cance.…”

Section: Disease Severitymentioning

confidence: 99%

See 4 more Smart Citations

Clinical utility of cycle threshold values in the context of COVID-19

Rao¹,

Manissero

Steele

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundThe ability to predict likely prognosis and infectiousness for patients with COVID-19 would aid patient management decisions. Diagnosis is usually via real-time PCR and it is unclear whether the semi-quantitative capability of this method, determining viral load through cycle threshold (Ct) values, can be leveraged.ObjectivesWe aim to review available knowledge on correlations between SARS-COV-2 Ct values and patient- or healthcare-related outcomes to determine whether Ct values provide useful clinical information.SourcesA PubMed search was conducted on 1st June 2020 based on a search strategy of (Ct value OR viral load) AND SARS-CoV-2. Data was extracted from studies reporting on the presence or absence of an association between Ct values, or viral loads determined via Ct value, and clinical outcomes.ContentData from 18 studies were relevant for inclusion. One study reported on the correlation between Ct values and mortality and one study reported on the correlation between Ct values and progression to severe disease; both reported a significant association (p < 0.001 and p = 0.008, respectively). Fourteen studies reported on the correlation between Ct value or viral loads determined via Ct value and disease severity and an association was observed in 8 (57%) studies. Studies reporting on the correlation of viral load with biochemical and haematological markers showed an association with at least one marker, including increased lactate dehydrogenase (n = 4), decreased lymphocytes (n = 3) and increased high-sensitivity troponin I (n = 2). Two studies reporting on the correlation with infectivity showed that lower Ct values were associated with higher viral culture positivity.ImplicationsData suggest that lower Ct values may be associated with worse outcomes, and that Ct values may be useful in predicting the clinical course and prognosis of patients with COVID-19; however, further studies are warranted to confirm clinical value.

show abstract

Section: Disease Progressionmentioning

confidence: 90%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Disease Severitymentioning

confidence: 99%

Section: Disease Severitymentioning

confidence: 99%

See 3 more Smart Citations

Clinical utility of cycle threshold values in the context of COVID-19

Rao¹,

Manissero

Steele

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

Evaluation of Rooming-in Practice for Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italy

et al. 2021

View full text Add to dashboard Cite

IMPORTANCEThe management of mother-infant dyads during the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic constitutes a major issue for neonatologists. In mothers with SARS-CoV-2 infection, current recommendations suggest either to separate the dyad or encourage protected rooming-in under appropriate precautions. No data are available regarding the risk of mother-to-infant transmission of SARS-CoV-2 during rooming-in.OBJECTIVE To evaluate the risk of postnatal transmission of SARS-CoV-2 from infected mothers to their neonates following rooming-in and breastfeeding. DESIGN, SETTING, AND PARTICIPANTSA prospective, multicenter study enrolling mother-infant dyads from March 19 to May 2, 2020, followed up for 20 days of life (range, 18-22 days), was performed. The study was conducted at 6 coronavirus disease 2019 maternity centers in Lombardy, Northern Italy. Participants included 62 neonates born to 61 mothers with SARS-CoV-2 infection who were eligible for rooming-in practice based on the clinical condition of the mother and infants whose results of nasopharyngeal swabs were negative at birth. EXPOSURES Mothers with SARS-CoV-2 infection were encouraged to practice rooming-in and breastfeeding under a standardized protocol to minimize the risk of viral transmission.MAIN OUTCOMES AND MEASURES Clinical characteristics and real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 on neonatal nasopharyngeal swabs at 0, 7, and 20 days of life. RESULTSOf the 62 neonates enrolled (25 boys), born to 61 mothers (median age, 32 years; interquartile range, 28-36 years), only 1 infant (1.6%; 95% CI, 0%-8.7%) was diagnosed as having SARS-CoV-2 infection at postbirth checks. In that case, rooming-in was interrupted on day 5 of life because of severe worsening of the mother's clinical condition. The neonate became positive for the virus on day 7 of life and developed transient mild dyspnea. Ninety-five percent of the neonates enrolled were breastfed. CONCLUSIONS AND RELEVANCEThe findings of this cohort study provide evidence-based information on the management of mother-infant dyads in case of SARS-CoV-2 maternal infection suggesting that rooming-in and breastfeeding can be practiced in women who are able to care for their infants.

show abstract

SARS‐CoV‐2 infection inIndiabucks the trend: Trained innate immunity?

Chinnaswamy

2020

American J Hum Biol

View full text Add to dashboard Cite

SARS‐CoV‐2, the causative agent of COVID‐19 pandemic caught the world unawares by its sudden onset in early 2020. Memories of the 1918 Spanish Flu were rekindled raising extreme fear for the virus, but in essence, it was the host and not the virus, which was deciding the outcome of the infection. Age, gender, and preexisting conditions played critical roles in shaping COVID‐19 outcome. People of lower socioeconomic strata were disproportionately affected in industrialized countries such as the United States. India, a developing country with more than 1.3 billion population, a large proportion of it being underprivileged and with substandard public health provider infrastructure, feared for the worst outcome given the sheer size and density of its population. Six months into the pandemic, a comparison of COVID‐19 morbidity and mortality data between India, the United States, and several European countries, reveal interesting trends. While most developed countries show curves expected for a fast‐spreading respiratory virus, India seems to have a slower trajectory. As a consequence, India may have gained on two fronts: the spread of the infection is unusually prolonged, thus leading to a curve that is “naturally flattened”; concomitantly the mortality rate, which is a reflection of the severity of the disease has been relatively low. I hypothesize that trained innate immunity, a new concept in immunology, may be the phenomenon behind this. Biocultural, socioecological, and socioeconomic determinants seem to be influencing the outcome of COVID‐19 in different regions/countries of the world.

show abstract

SARS-CoV-2 viral load in sputum correlates with risk of COVID-19 progression

Cited by 174 publications

References 4 publications

Clinical utility of cycle threshold values in the context of COVID-19

Clinical utility of cycle threshold values in the context of COVID-19

Evaluation of Rooming-in Practice for Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italy

SARS‐CoV‐2 infection inIndiabucks the trend: Trained innate immunity?

Contact Info

Product

Resources

About