Journal of International Medical Research (Nov 2022)

Is SARS-CoV-2 viral load a predictor of mortality in COVID-19 acute respiratory distress syndrome patients?

  • Lerzan Dogan,
  • Aytaj Allahverdiyeva,
  • Mustafa Önel,
  • Sevim Meşe,
  • Esra Saka Ersin,
  • İlkay Anaklı,
  • Zeynep Tuğçe Sarıkaya,
  • Rehile Zengin,
  • Bulent Gucyetmez,
  • Neval Yurtturan Uyar,
  • Perihan Ergin Özcan,
  • Ayse Sesin Kocagöz,
  • Hayriye Kırkoyun Uysal,
  • İbrahim Ozkan Akinci,
  • Ali Ağaçfidan

DOI
https://doi.org/10.1177/03000605221137443
Journal volume & issue
Vol. 50

Abstract

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Objective Viral load varies during infection and is higher during the initial stages of disease. Given the importance of the intensive care unit (ICU) in the late stages of COVID-19 infection, analyzing cycle threshold values to detect viral load upon ICU admission can be a clinically valuable tool for identifying patients with the highest mortality risk. Methods This was a retrospectively designed study. Patients older than 18 years who tested positive for SARS-CoV-2 PCR and had a PaO 2 /FiO 2 ratio <200 were included in the study. The patient population was divided into two groups: survivors and non-survivors. Results Two hundred patients were included in the study. In non-survivors, age, relevant ICU admission scores, and procalcitonin levels were significantly higher whereas PaO 2 /FiO 2 ratios and cycle threshold levels were significantly lower than in survivors. Conclusion Viral load at ICU admission has significant prognostic value. In combination with age, comorbidities, and severity scores, viral load may assist clinicians in identifying individuals who need more intensive monitoring. Increased awareness may improve outcomes by allowing the more effective monitoring and treatment of patients. More prospective studies are needed to determine how a high viral load worsens disease and how to avoid irreversible results.