SARS-CoV-2 Cycle Thresholds, Poverty, Race, and Clinical Outcomes

Poverty and high viral load are associated with worse outcomes among COVID-19 patients.We included patients admitted to Froedtert Health between March 16 and June 1, 2020. SARS-CoV-2 viral load was proxied by cycle-threshold values. To measure poverty, we used Medicaid or uninsured status and residence in socially disadvantaged areas. We assessed the association between viral load and length of stay and discharge disposition, while controlling for demographics and confounders.Higher viral load was associated with longer length of stay (coefficient -0.02; 95% CI, -0.04 to 0.01; P = 0.006) and higher likelihood of death (coefficient -0.11; 95% CI, -0.17 to -0.06; P 0.001). Poverty, residence in disadvantaged areas, and race were not.This study confirms a relationship of viral load with in-hospital death, even after controlling for race and poverty.