SARS-CoV-2 viral load is associated with increased disease severity and mortality
Jesse Fajnzylber(Brigham and Women's Hospital), James Regan(Brigham and Women's Hospital), Kendyll Coxen(Brigham and Women's Hospital), Heather Corry(Brigham and Women's Hospital), Colline Wong(Brigham and Women's Hospital), Alexandra Rosenthal(Brigham and Women's Hospital), Daniel Worrall(Harvard University), Françoise Giguel(Harvard University), Alicja Piechocka‐Trocha(Harvard University), Caroline Atyeo(Harvard University), Stephanie Fischinger(Harvard University), Andrew T. Chan(Harvard University), Keith T. Flaherty(Harvard University), Kathryn Hall(Harvard University), Michael Dougan(Harvard University), Edward T. Ryan(Harvard University), Elizabeth Gillespie(Brigham and Women's Hospital), Rida Chishti(Brigham and Women's Hospital), Yijia Li(Brigham and Women's Hospital), Nikolaus Jilg(Brigham and Women's Hospital), Dusan Hanidziar(Harvard University), Rebecca M. Baron(Brigham and Women's Hospital), Lindsey R. Baden(Brigham and Women's Hospital), Athe Tsibris(Brigham and Women's Hospital), Katrina Armstrong(Harvard University), Daniel R. Kuritzkes(Brigham and Women's Hospital), Galit Alter(Harvard University), Bruce D. Walker(Howard Hughes Medical Institute), Xu G. Yu(Harvard University), Jonathan Z. Li(Brigham and Women's Hospital), Betelihem A. Abayneh, Patrick Allen(Harvard University), Diane Antille(Harvard University), Alejandro B. Balazs(Harvard University), Julia Bals(Harvard University), Max Barbash(Harvard University), Yannic C. Bartsch(Harvard University), Julie Boucau(Harvard University), Siobhan Boyce(Harvard University), Joan Braley(Harvard University), Karen Branch(Harvard University), Katherine Broderick(Harvard University), Julia Carney(Harvard University), Joshua M Chevalier(Harvard University), Manish C. Choudhary(Brigham and Women's Hospital), Navin Chowdhury(Harvard University), Trevor Cordwell(Brigham and Women's Hospital), George Q. Daley(Harvard University), Susan Davidson(Harvard University), Michaël Desjardins(Brigham and Women's Hospital), Lauren Donahue(Brigham and Women's Hospital), David A. Drew(Harvard University), Kevin Einkauf(Harvard University), Sampson Elizabeth(Brigham and Women's Hospital), Ashley Elliman(Harvard University), Behzad Etemad(Brigham and Women's Hospital), Jon Fallon(Harvard University), Liz Fedirko(Harvard University), Kelsey Finn(Harvard University), Jeanne Flannery(Harvard University), Pamela J. Forde(Harvard University), Pilar García‐Broncano(Harvard University), Elise Gettings(Harvard University), David Golan(Harvard University), Kirsten Goodman(Brigham and Women's Hospital), Amanda Griffin(Harvard University), Sheila Grimmel(Harvard University), Kathleen Grinke(Harvard University), Ciputra Adijaya Hartana(Harvard University), Meg Healy(Harvard University), Howard M. Heller(Harvard University), Deborah Henault(Harvard University), Grace Holland(Harvard University), Chenyang Jiang(Harvard University), Hannah Jordan(Brigham and Women's Hospital), Paulina Kapłonek(Harvard University), Elizabeth W. Karlson(Brigham and Women's Hospital), Marshall Karpell(Harvard University), Chantal Kayitesi(Harvard University), Evan C. Lam(Harvard University), Vlasta LaValle(Harvard University), Kristina Lefteri(Harvard University), Xiaodong Lian(Harvard University), Mathias Lichterfeld(Brigham and Women's Hospital), Daniel Lingwood(Harvard University), Hang Liu(Harvard University), Jin-Qing Liu(Harvard University), K. A. J. Lopez(Brigham and Women's Hospital), Yuting Lu(Harvard University), Sarah Luthern(Harvard University), Ngoc L. Ly(Harvard University), Maureen MacGowan(Brigham and Women's Hospital), Karen Magispoc(Brigham and Women's Hospital), Jordan Marchewka(Harvard University), Brittani Martino(Harvard University), Roseann McNamara(Harvard University), Ashlin R. Michell(Harvard University), Ilan Millstrom(Harvard University), Noah Miranda(Harvard University), Christian Nambu(Harvard University), Susan C. Nelson(Harvard University), Marjorie Noone(Harvard University), Lewis A. Novack(Brigham and Women's Hospital), Claire O’Callaghan(Harvard University), Christine Ommerborn(Harvard University), Matthew R. Osborn(Harvard University), Lois Chris Pacheco(Harvard University), Nicole Phan(Harvard University), Shiv Pillai(Harvard University), Falisha A. Porto(Harvard University), Yelizaveta Rassadkina(Harvard University), Alexandra Reissis(Harvard University), Francis F. Ruzicka(Harvard University), Kyra Seiger(Harvard University), Kathleen Selleck(Harvard University), Libera Sessa(Harvard University), Arlene Sharpe(Harvard University), Christianne Sharr(Harvard University), Sally Shin(Harvard University), Nishant K. Singh(Harvard University), Sue Slaughenhaupt(Harvard University), Kimberly Smith Sheppard(Harvard University), Weiwei Sun(Harvard University), Xiaoming Sun(Harvard University), Elizabeth Suschana(Brigham and Women's Hospital), Opeyemi Talabi(Brigham and Women's Hospital), Hannah Ticheli(Harvard University), Scott T. Weiss(Brigham and Women's Hospital), Vivine Wilson(Harvard University), Alex Zhu(Harvard University)
Cited by 976Open Access
Abstract
The 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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