2022
DOI: 10.3390/v14061292
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SARS-CoV-2 Viral Load in the Pulmonary Compartment of Critically Ill COVID-19 Patients Correlates with Viral Serum Load and Fatal Outcomes

Abstract: While SARS-CoV-2 detection in sputum and swabs from the upper respiratory tract has been used as a diagnostic tool, virus quantification showed poor correlation to disease outcome and thus, poor prognostic value. Although the pulmonary compartment represents a relevant site for viral load analysis, limited data exploring the lower respiratory tract is available, and its association to clinical outcomes is relatively unknown. Using bronchoalveolar lavage (BAL) and serum samples, we quantified SARS-CoV-2 copy nu… Show more

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Cited by 14 publications
(14 citation statements)
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“…Given the total # and wide variability in the severity of microscopic features between patients that died of severe SARS-2 infection, we sought to localize and quantify viral burden in the lungs utilizing immunofluorescence staining and identified a dichotomous population of patients that died with severe SARS-2 infection harboring either high or low viral load. This variability in viral lung burden is consistent with prior studies utilizing quantitative PCR and in situ RNA hybridization 43 , 44 , 45 , 46 Viral burden also correlated with ICU duration (r: 0.33) as well as the total duration of infection (>/= 21 days; r: 0.53). This may be due to delayed viral clearance as a result of intrinsic or iatrogenic immune impairment due to corticosteroid therapy, which is known to prolong viral infection and render patients susceptible to 2° infection 47 , 48 .…”
Section: Discussionsupporting
confidence: 88%
“…Given the total # and wide variability in the severity of microscopic features between patients that died of severe SARS-2 infection, we sought to localize and quantify viral burden in the lungs utilizing immunofluorescence staining and identified a dichotomous population of patients that died with severe SARS-2 infection harboring either high or low viral load. This variability in viral lung burden is consistent with prior studies utilizing quantitative PCR and in situ RNA hybridization 43 , 44 , 45 , 46 Viral burden also correlated with ICU duration (r: 0.33) as well as the total duration of infection (>/= 21 days; r: 0.53). This may be due to delayed viral clearance as a result of intrinsic or iatrogenic immune impairment due to corticosteroid therapy, which is known to prolong viral infection and render patients susceptible to 2° infection 47 , 48 .…”
Section: Discussionsupporting
confidence: 88%
“…The viral load in the lower respiratory tract correlates with the progression of the disease and severity of the symptoms [ 28 , 29 ]. Hence, we measured the viral loads in the lungs, trachea and nasal washes at 3 dpi.…”
Section: Resultsmentioning
confidence: 99%
“… 7 , 8 Evidence from previous studies suggests that the concentration of SARS-CoV-2 RNA in plasma or serum is a surrogate of the degree of viral replication in the lower respiratory tract. 9 , 10 By contrast with samples from the lower respiratory tract, plasma constitutes a matrix with a more homogeneous composition that can be easily collected from patients with or without invasive mechanical ventilation, contributing to building a more comprehensive picture of the participation of the virus in the critical illness induced by COVID-19. Moreover, viral RNA load profiled in plasma seems to be a better predictor of outcome than that profiled in samples from the lower respiratory tract.…”
Section: Introductionmentioning
confidence: 99%