Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study

作者：Shufa Zheng, Jian‐Gao Fan, Fei Yu, Baihuan Feng, Bin Lou, Qianda Zou, Guoliang Xie, Sha Lin, Ruonan Wang, Xianzhi Yang, Weizhen Chen, Qi Wang, Dan Zhang, Yanchao Liu, Renjie Gong, Zhaohui Ma, Siming Lu, Yanyan Xiao, Yaxi Gu, Jinming Zhang, Hangping Yao, Kaijin Xu, Xiaoyang Lu, Guoqing Wei, Jianying Zhou, Qiang Fang, Hongliu Cai, Yunqing Qiu, Jifang Sheng, Yu Chen, Tingbo Liang · 发表于：BMJ · 年份：2020 · DOI：10.1136/bmj.m1443 · 被引用次数：1593 · 研究领域：SARS-CoV-2 detection and testing、COVID-19 Clinical Research Studies、SARS-CoV-2 and COVID-19 Research

OBJECTIVE: To evaluate viral loads at different stages of disease progression in patients infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first four months of the epidemic in Zhejiang province, China. DESIGN: Retrospective cohort study. SETTING: A designated hospital for patients with covid-19 in Zhejiang province, China. PARTICIPANTS: 96 consecutively admitted patients with laboratory confirmed SARS-CoV-2 infection: 22 with mild disease and 74 with severe disease. Data were collected from 19 January 2020 to 20 March 2020. MAIN OUTCOME MEASURES: Ribonucleic acid (RNA) viral load measured in respiratory, stool, serum, and urine samples. Cycle threshold values, a measure of nucleic acid concentration, were plotted onto the standard curve constructed on the basis of the standard product. Epidemiological, clinical, and laboratory characteristics and treatment and outcomes data were obtained through data collection forms from electronic medical records, and the relation between clinical data and disease severity was analysed. RESULTS: 3497 respiratory, stool, serum, and urine samples were collected from patients after admission and evaluated for SARS-CoV-2 RNA viral load. Infection was confirmed in all patients by testing sputum and saliva samples. RNA was detected in the stool of 55 (59%) patients and in the serum of 39 (41%) patients. The urine sample from one patient was positive for SARS-CoV-2. The median duration of virus in stoo...