Back to Search
Start Over
Protracted viral shedding and viral load are associated with ICU mortality in Covid-19 patients with acute respiratory failure
- Source :
- Annals of Intensive Care, Vol 10, Iss 1, Pp 1-9 (2020), Annals of Intensive Care
- Publication Year :
- 2020
- Publisher :
- SpringerOpen, 2020.
-
Abstract
- BackgroundProtracted viral shedding is common in hospitalized patients with COVID-19 pneumonia, and up to 40% display signs of pulmonary fibrosis on computed tomography (CT) after hospital discharge. We hypothesized that COVID-19 patients with acute respiratory failure (ARF) who die in intensive care units (ICU) have a lower viral clearance in the respiratory tract than ICU patients discharged alive, and that protracted viral shedding in respiratory samples is associated with patterns of fibroproliferation on lung CT. We, therefore, conducted a retrospective observational study, in 2 ICU of Lyon university hospital.Results129 patients were included in the study, of whom 44 (34%) died in ICU. 432 RT-PCR for SARS-CoV-2 were performed and 137 CT scans were analyzed. Viral load was significantly higher in patients deceased as compared to patients alive at ICU discharge (p 95 %:15–21] in patients alive at ICU discharge and 26 days [CI95 %:17-infinity] in non-survivors at ICU discharge. Competitive risk regression identified patients who died in ICU and age as independent risk factors for longer time to SARS-CoV-2 negativation on RT-PCR, while antiviral treatment was independently associated with shorter time. None of the CT scores exploring fibroproliferation (i.e., bronchiectasis and reticulation scores) were significantly associated with time to SARS-CoV-2 negativation.ConclusionsViral load in respiratory samples is significantly lower and viral shedding significantly shorter in ICU survivors of COVID-19 associated acute respiratory failure. Protracted viral shedding is unrelated to occurrence of fibrosis on lung CT.
- Subjects :
- medicine.medical_specialty
SARS-COV-2
Critical Care and Intensive Care Medicine
Acute respiratory failure
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Internal medicine
Intensive care
Pulmonary fibrosis
medicine
Viral load
030212 general & internal medicine
Viral shedding
Bronchiectasis
Lung
Acute respiratory distress syndrome
business.industry
Research
lcsh:Medical emergencies. Critical care. Intensive care. First aid
COVID-19
Retrospective cohort study
lcsh:RC86-88.9
medicine.disease
Polymerase chain reaction
Pneumonia
medicine.anatomical_structure
business
Subjects
Details
- Language :
- English
- ISSN :
- 21105820
- Volume :
- 10
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Annals of Intensive Care
- Accession number :
- edsair.doi.dedup.....fa7679f6f2e378db7e4e04a5a1bf4c1b