Investigation of viral load in patients with Coronavirus disease-2019 with and without comorbidities

Abstract

Aims: Many fatal cases of Coronavirus disease-2019 (COVID-19) involved patients with comorbidities, in which a higher cellular viral copy was frequently reported. This study aimed to compare viral load (VL) among patients with COVID-19 with and without comorbidities. Methods: This retrospective case-control study included COVID-19 patients with and without comorbidities who were hospitalized in two COVID-19 referral hospitals, Tanjungpura University Hospital and Doctor Soedarso General Hospital, in West Kalimantan, Indonesia. Demographic findings, clinical symptoms, comorbidities, and real-time polymerase chain reaction VL data were collected from medical records. Results: This study included 136 patients (53% female and 47% male) divided equally into 68 patients with [median age interquartile range (IQR): 47 (40-58.5) years] and without comorbidities [median age (IQR): 25 (22-35.8) years]. A total of 48.5% of patients with comorbidities experienced severe COVID-19, whereas 61.8% of patients without comorbidities merely exhibited mild symptoms. The presence of comorbidities demonstrated a significant association with age and COVID-19 severity (p<0.001), with a trend of elevated VL among individuals with comorbidities (p=0.023, median: log10 1.86 vs 1.34 VL). Significant differences in VL were found between age groups (p=0.019) and COVID-19 severities (p=0.001), showing higher VL among older, moderately ill, and critically ill patients. Critical condition was experienced by COVID-19 patients with hypertension, cardiovascular disease, diabetes, and chronic obstructive pulmonary disease. Severe COVID-19 was observed in nearly all comorbid conditions, except in pregnant women and those with malignancies. Conclusions: VL differed significantly between patients with and without comorbidities, age groups, and degrees of COVID-19 presentation. VL holds promise in monitoring disease progression in patients with COVID-19, particularly those with comorbidities.

Keywords

• covid-19
• comorbidity
• viral load