1. Changes in SARS-CoV-2 viral load and mortality during the initial wave of the pandemic in New York City
- Author
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Mangala Rajan, Benjamin R. Baer, Michael J. Satlin, Martin T. Wells, Nathaniel Hupert, Monika M. Safford, Parag Goyal, Jason Zucker, Lars F. Westblade, Yanhan Shen, Luis M. Schang, Laura C. Pinheiro, Magdalena E. Sobieszczyk, and Jorge L Sepulveda
- Subjects
Male ,RNA viruses ,Viral Diseases ,Critical Care and Emergency Medicine ,Coronaviruses ,Epidemiology ,viruses ,Artificial Gene Amplification and Extension ,Polymerase Chain Reaction ,Medical Conditions ,Pandemic ,Medicine and Health Sciences ,Medicine ,Hospital Mortality ,Pathology and laboratory medicine ,Virus Testing ,Multidisciplinary ,Incidence (epidemiology) ,Mortality rate ,Viral Load ,Medical microbiology ,Infectious Diseases ,COVID-19 Nucleic Acid Testing ,Viruses ,Female ,SARS CoV 2 ,Pathogens ,Viral load ,Research Article ,medicine.medical_specialty ,SARS coronavirus ,Coronavirus disease 2019 (COVID-19) ,Death Rates ,Science ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,New York ,Research and Analysis Methods ,Microbiology ,Population Metrics ,Diagnostic Medicine ,Virology ,Internal medicine ,Humans ,Molecular Biology Techniques ,Pandemics ,Molecular Biology ,Cycle threshold ,Population Biology ,SARS-CoV-2 ,business.industry ,Organisms ,Viral pathogens ,COVID-19 ,Biology and Life Sciences ,Covid 19 ,Reverse Transcriptase-Polymerase Chain Reaction ,Odds ratio ,Microbial pathogens ,business ,Viral Transmission and Infection - Abstract
Public health interventions such as social distancing and mask wearing decrease the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but it is unclear whether they decrease the viral load of infected patients and whether changes in viral load impact mortality from coronavirus disease 2019 (COVID-19). We evaluated 6923 patients with COVID-19 at six New York City hospitals from March 15-May 14, 2020, corresponding with the implementation of public health interventions in March. We assessed changes in cycle threshold (CT) values from reverse transcription-polymerase chain reaction tests and in-hospital mortality and modeled the impact of viral load on mortality. Mean CT values increased between March and May, with the proportion of patients with high viral load decreasing from 47.7% to 7.8%. In-hospital mortality increased from 14.9% in March to 28.4% in early April, and then decreased to 8.7% by May. Patients with high viral loads had increased mortality compared to those with low viral loads (adjusted odds ratio 2.34). If viral load had not declined, an estimated 69 additional deaths would have occurred (5.8% higher mortality). SARS-CoV-2 viral load steadily declined among hospitalized patients in the setting of public health interventions, and this correlated with decreases in mortality.
- Published
- 2021
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