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High anal swab viral load predisposes adverse clinical outcomes in severe COVID-19 patients.
Emerg Microbes Infect. 2020 Dec; 9(1):2707-2714.EM

Abstract

To identify the association between the kinetics of viral load and clinical outcome in severe coronavirus disease 2019 (COVID-19) patients, a retrospective study was performed by involved 188 hospitalized severe COVID-19 patients in the LOTUS China trial. Among the collected 578 paired throat swab (TS) and anal swab (AS) samples, viral RNA was detected in 193 (33.4%) TS and 121 (20.9%) AS. A higher viral RNA load was found in TS than that of AS, with means of 1.0 × 106 and 2.3 × 105 copies/ml, respectively. In non-survivors, the viral RNA in AS was detected earlier than that in survivors (median of 14 days vs 19 days, P = 0.007). The positivity and viral load in AS were higher in non-survivors than that of survivors at week 2 post symptom onset (P = 0.006). A high initial viral load in AS was associated with death (OR 1.368, 95% CI 1.076-1.741, P = 0.011), admission to the intensive care unit (OR 1.237, 95% CI 1.001-1.528, P = 0.049) and need for invasive mechanical ventilation (OR 1.340, 95% CI 1.076-1.669, P = 0.009). Our findings indicated viral replication in extrapulmonary sites should be monitored intensively during antiviral therapy.

Authors+Show Affiliations

Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, People's Republic of China. Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China. Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, People's Republic of China. Department of Respiratory Medicine, Capital Medical University, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China. Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China. Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.Department of Tuberculosis and Respiratory Disease, Jinyintan Hospital, Wuhan, People's Republic of China.Department of Tuberculosis and Respiratory Disease, Jinyintan Hospital, Wuhan, People's Republic of China.Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, People's Republic of China.Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, People's Republic of China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, People's Republic of China. Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, People's Republic of China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, People's Republic of China. Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, People's Republic of China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, People's Republic of China. Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, People's Republic of China. Department of Respiratory Medicine, Capital Medical University, Beijing, People's Republic of China. Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, People's Republic of China.NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China. Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33259268

Citation

Li, Haibo, et al. "High Anal Swab Viral Load Predisposes Adverse Clinical Outcomes in Severe COVID-19 Patients." Emerging Microbes & Infections, vol. 9, no. 1, 2020, pp. 2707-2714.
Li H, Ren L, Zhang L, et al. High anal swab viral load predisposes adverse clinical outcomes in severe COVID-19 patients. Emerg Microbes Infect. 2020;9(1):2707-2714.
Li, H., Ren, L., Zhang, L., Wang, Y., Guo, L., Wang, C., Xiao, Y., Wang, Y., Rao, J., Wang, X., Liu, Y., Huang, C., Gu, X., Fan, G., Li, H., Lu, B., Cao, B., & Wang, J. (2020). High anal swab viral load predisposes adverse clinical outcomes in severe COVID-19 patients. Emerging Microbes & Infections, 9(1), 2707-2714. https://doi.org/10.1080/22221751.2020.1858700
Li H, et al. High Anal Swab Viral Load Predisposes Adverse Clinical Outcomes in Severe COVID-19 Patients. Emerg Microbes Infect. 2020;9(1):2707-2714. PubMed PMID: 33259268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High anal swab viral load predisposes adverse clinical outcomes in severe COVID-19 patients. AU - Li,Haibo, AU - Ren,Lili, AU - Zhang,Lulu, AU - Wang,Yeming, AU - Guo,Li, AU - Wang,Conghui, AU - Xiao,Yan, AU - Wang,Ying, AU - Rao,Jian, AU - Wang,Xinming, AU - Liu,Ying, AU - Huang,Chaolin, AU - Gu,Xiaoying, AU - Fan,Guohui, AU - Li,Hui, AU - Lu,Binghuai, AU - Cao,Bin, AU - Wang,Jianwei, PY - 2020/12/2/pubmed PY - 2021/1/6/medline PY - 2020/12/1/entrez KW - COVID-19 KW - SARS-CoV-2 KW - anal swabs KW - clinical outcome KW - viral load SP - 2707 EP - 2714 JF - Emerging microbes & infections JO - Emerg Microbes Infect VL - 9 IS - 1 N2 - To identify the association between the kinetics of viral load and clinical outcome in severe coronavirus disease 2019 (COVID-19) patients, a retrospective study was performed by involved 188 hospitalized severe COVID-19 patients in the LOTUS China trial. Among the collected 578 paired throat swab (TS) and anal swab (AS) samples, viral RNA was detected in 193 (33.4%) TS and 121 (20.9%) AS. A higher viral RNA load was found in TS than that of AS, with means of 1.0 × 106 and 2.3 × 105 copies/ml, respectively. In non-survivors, the viral RNA in AS was detected earlier than that in survivors (median of 14 days vs 19 days, P = 0.007). The positivity and viral load in AS were higher in non-survivors than that of survivors at week 2 post symptom onset (P = 0.006). A high initial viral load in AS was associated with death (OR 1.368, 95% CI 1.076-1.741, P = 0.011), admission to the intensive care unit (OR 1.237, 95% CI 1.001-1.528, P = 0.049) and need for invasive mechanical ventilation (OR 1.340, 95% CI 1.076-1.669, P = 0.009). Our findings indicated viral replication in extrapulmonary sites should be monitored intensively during antiviral therapy. SN - 2222-1751 UR - https://www.unboundmedicine.com/medline/citation/33259268/High_anal_swab_viral_load_predisposes_adverse_clinical_outcomes_in_severe_COVID_19_patients_ L2 - https://www.tandfonline.com/doi/full/10.1080/22221751.2020.1858700 DB - PRIME DP - Unbound Medicine ER -