SARS-CoV-2 viral load is associated with increased disease severity and mortality

作者：Jesse M. Fajnzylber, James B. Regan, Kendyll Coxen, Heather Corry, Colline Wong, Alexandra Rosenthal, Daniel P. Worrall, Francoise F. Giguel, Alicja Piechocka‐Trocha, Caroline G. Atyeo, Stephanie Fischinger, Andrew Tan Chan, Keith T. Flaherty, Kathryn Hall, Michael Lawrence Dougan, Edward Thomas Ryan, Elizabeth E. Gillespie, Rida Chishti, Yijia Li, Nikolaus Jilg, Dusan Hanidziar, Rebecca Marlene Baron, Lindsey Robert Baden, Athe M. N. Tsibris, Katrina Armstrong, Daniel R. Kuritzkes, Galit Alter, Bruce D. Walker, Xu G. Yu, Jonathan Z. Li, Betelihem A. Abayneh, Patrick Allen, Diane Antille, Alejandro Benjamin Balazs, Julia Bals, Max Barbash, Yannic C. Bartsch, Julie Boucau, Siobhan Boyce, Joan Braley, Karen Branch, Katherine T. Broderick, Julia R. Carney, Joshua M Chevalier, Manish Chandra Choudhary, Navin Chowdhury, Trevor Cordwell, George Q. Daley, Susan P. Davidson, Michael C. Desjardins, Lauren Donahue, David A. Drew, Kevin B. Einkauf, Sampson Elizabeth, Ashley Elliman, Behzad Etemad, Jon K. Fallon, Liz Fedirko, Kelsey K. Finn, Jeanne C. Flannery, Pamela J. Forde, Pilar García‐Broncano, Elise M. Gettings, David Golan, Kirsten Goodman, Amanda M. Griffin, Sheila Grimmel, Kathleen A. Grinke, Ciputra Adijaya Hartana, Meg Healy, Howard M. Heller, Deborah Henault, Grace Holland, Chenyang Jiang, Hannah T. Jordan, Paulina Kapłonek, Elizabeth W. Karlson, Marshall Karpell, Chantal Kayitesi, Evan Christopher Lam, Vlasta LaValle, Kristina Lefteri, Xiaodong Lian, Mathias D. Lichterfeld, Daniel Lingwood, Hang Liu, Jin-Qing Liu, K. A. J. Lopez, Yuting Lu, Sarah Luthern, Ngoc L. Ly, Maureen MacGowan, Karen Magispoc, Jordan Marchewka, Brittani Martino, Roseann McNamara, Ashlin R. Michell, Ilan Millstrom, Noah Miranda, Christian Nambu, Susan C. Nelson, Marjorie Noone, Lewis A. Novack, Claire O’Callaghan, Christine Ommerborn, Matthew R. Osborn, Lois Chris Pacheco, Nicole Phan, Shiv S Pillai, Falisha A. Porto, Yelizaveta Rassadkina, Alexandra Reissis, Francis F. Ruzicka, Kyra W. Seiger, Kathleen Selleck, Libera Sessa, Arlene Sharpe, Christianne Sharr, Sally A. Shin, Nishant Kumar Singh, Sue Slaughenhaupt, Kimberly Smith Sheppard, Weiwei Sun, Xiaoming Sun, Elizabeth Suschana, Opeyemi Talabi, Hannah J. Ticheli, Scott T. Weiss, Vivine Wilson, Alex Lee Zhu · 发表于：Nature Communications · 年份：2020 · DOI：10.1038/s41467-020-19057-5 · 被引用次数：983 · 研究领域：COVID-19 Clinical Research Studies、SARS-CoV-2 and COVID-19 Research、COVID-19 epidemiological studies

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.