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 × 10 6 and 2.3 × 10 5 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.
【저자키워드】 COVID-19, SARS-CoV-2, Clinical outcome, Viral load, anal swabs, 【초록키워드】 coronavirus disease, antiviral therapy, Coronavirus disease 2019, Hospitalized, Trial, intensive care, intensive care unit, Clinical outcome, China, Retrospective study, Kinetics, Viral, Viral load, viral replication, death, Viral RNA, anal swab, viral RNA load, Admission, patients, association, Invasive mechanical ventilation, symptom onset, Non-survivors, 95% CI, severe coronavirus disease, throat swab, survivor, extrapulmonary sites, non-survivor, initial viral load, identify, collected, involved, indicated, was performed, median, severe COVID-19 patient, 【제목키워드】 Viral, severe COVID-19 patient,