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Research
High viral load suggests increased COVID-19 severity in a longitudinal cohort
Hongbing Shen
Nanjing Medical University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: An outbreak caused by the 2019 novel coronavirus (2019-nCoV) has spread globally. However, the viral dynamics, co-infection and their associations with clinical severity, have not been well explored.
Methods: We longitudinally enrolled 23 (Five severe-type, ten common-type and eight asymptomatic-type patients) hospitalized 2019-nCov-infected patients in Jiangsu between January 21 and February 11, 2020. Medical records and pharyngeal swab specimens, were collected to analyze the association between viral dynamic and disease severity.
Results: Five severe-type, ten common-type and eight asymptomatic-type patients were enrolled. Linear mixed effects models revealed that the common and severe-type patients had a higher level of viral load (3.08 points, 95% CI, 0.51-5.65, P = 0.019; 6.07 points, 95% CI, 2.79-9.35, P < 0.001) and maintained a higher peak viral load ( P = 0.066 and 0.022, respectively), when compared with the asymptomatic group. Viral load shedding among older patients (aged ≥ 60) processed slower than that among younger patients ( P = 0.047). RNA virome sequencing identified two co-infected RNA viruses, Human endogenous retrovirus H (HERV) and Human picobirnavirus (HPBV). Of note, HPBV was detected in one severe-type and two common-type patients, while was not detected in all the asymptomatic cases.
Conclusion: Higher viral load was positively associated with disease severity. This finding highlights the importance of monitoring the viral kinetics to identify patients at greater risk of progressing to severe pneumonia.
Keywords
2019 novel coronavirus, viral load, co-infection, HPBV
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stella
commented on 06 September, 2020
Honestly When I found out I had hiv , I was completely lost because I didn't know what to do and I worried about how the incident would affect my relationship. I couldn't go about it but positive thinking and a healthy approach keeps me going. I tried finding help in all possible area but my efforts were to no avail. But with the help of Dr Oduwa, I discussed the issue with him and I was treated so after some times I went back for another test which came out NEGATIVE and I was totally healed. And you can reach out to Dr Oduwa on this mail [email protected] whatsApp+23481363534191 or you can visit his website https://droduwaherbalhome.com/ and you will be the next to testify of his great work.
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This is a preprint. It has not completed peer review.
Research
High viral load suggests increased COVID-19 severity in a longitudinal cohort
Hongbing Shen
Nanjing Medical University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 12 Jun, 2020
Community comments: 1
Metrics
Comments: 1
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: An outbreak caused by the 2019 novel coronavirus (2019-nCoV) has spread globally. However, the viral dynamics, co-infection and their associations with clinical severity, have not been well explored.
Methods: We longitudinally enrolled 23 (Five severe-type, ten common-type and eight asymptomatic-type patients) hospitalized 2019-nCov-infected patients in Jiangsu between January 21 and February 11, 2020. Medical records and pharyngeal swab specimens, were collected to analyze the association between viral dynamic and disease severity.
Results: Five severe-type, ten common-type and eight asymptomatic-type patients were enrolled. Linear mixed effects models revealed that the common and severe-type patients had a higher level of viral load (3.08 points, 95% CI, 0.51-5.65, P = 0.019; 6.07 points, 95% CI, 2.79-9.35, P < 0.001) and maintained a higher peak viral load ( P = 0.066 and 0.022, respectively), when compared with the asymptomatic group. Viral load shedding among older patients (aged ≥ 60) processed slower than that among younger patients ( P = 0.047). RNA virome sequencing identified two co-infected RNA viruses, Human endogenous retrovirus H (HERV) and Human picobirnavirus (HPBV). Of note, HPBV was detected in one severe-type and two common-type patients, while was not detected in all the asymptomatic cases.
Conclusion: Higher viral load was positively associated with disease severity. This finding highlights the importance of monitoring the viral kinetics to identify patients at greater risk of progressing to severe pneumonia.
Figure 1
Figure 2
Figure 3
Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF.
stella
commented on 06 September, 2020
Honestly When I found out I had hiv , I was completely lost because I didn't know what to do and I worried about how the incident would affect my relationship. I couldn't go about it but positive thinking and a healthy approach keeps me going. I tried finding help in all possible area but my efforts were to no avail. But with the help of Dr Oduwa, I discussed the issue with him and I was treated so after some times I went back for another test which came out NEGATIVE and I was totally healed. And you can reach out to Dr Oduwa on this mail [email protected] whatsApp+23481363534191 or you can visit his website https://droduwaherbalhome.com/ and you will be the next to testify of his great work.