SARS-CoV-2 detection in the lower respiratory tract of invasively ventilated ARDS patients

Critical Care

Timothy Mazzuchelli¹  Valentina Forni Ogna¹  Enos Bernasconi²  Pierpaolo Trimboli³  Paul-Henri Wicky⁴  Stéphane Ruckly⁵  Ambre Loiodice⁵  Quentin Le Hingrat⁶  Benoit Visseaux⁶  Niccolò Buetti⁷  Etienne de Montmollin⁸  Jean-François Timsit⁸ 

[1] Ente Ospedaliero Cantonale, Locarno Community Hospital, Locarno, Switzerland;Ente Ospedialiero Cantonale, Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland;Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland;Clinic of Endocrinology and Diabetology, Lugano and Mendrisio Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland;Medical and Infectious Diseases ICU (MI2), Bichat-Claude Bernard Hospital, AP-HP, 75018, Paris, France;University of Paris, INSERM, IAME, F-75006, Paris, France;University of Paris, INSERM, IAME, F-75006, Paris, France;AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de virologie, F-75018, Paris, France;University of Paris, INSERM, IAME, F-75006, Paris, France;Ente Ospedaliero Cantonale, Locarno Community Hospital, Locarno, Switzerland;Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland;University of Paris, INSERM, IAME, F-75006, Paris, France;Medical and Infectious Diseases ICU (MI2), Bichat-Claude Bernard Hospital, AP-HP, 75018, Paris, France;

关键词: SARS-CoV-2;    COVID-19;    Viral shedding;    Viral load;    Lower respiratory tract;    ICU;    Mortality;   

DOI  :  10.1186/s13054-020-03323-5

来源: Springer

【 摘 要 】

BackgroundData on SARS-CoV-2 load in lower respiratory tract (LRT) are scarce. Our objectives were to describe the viral shedding and the viral load in LRT and to determine their association with mortality in critically ill COVID-19 patients.MethodsWe conducted a binational study merging prospectively collected data from two COVID-19 reference centers in France and Switzerland. First, we described the viral shedding duration (i.e., time to negativity) in LRT samples. Second, we analyzed viral load in LRT samples. Third, we assessed the association between viral presence in LRT and mortality using mixed-effect logistic models for clustered data adjusting for the time between symptoms’ onset and date of sampling.ResultsFrom March to May 2020, 267 LRT samples were performed in 90 patients from both centers. The median time to negativity was 29 (IQR 23; 34) days. Prolonged viral shedding was not associated with age, gender, cardiac comorbidities, diabetes, immunosuppression, corticosteroids use, or antiviral therapy. The LRT viral load tended to be higher in non-survivors. This difference was statistically significant after adjusting for the time interval between onset of symptoms and date of sampling (OR 3.78, 95% CI 1.13–12.64, p = 0.03).ConclusionsThe viral shedding in LRT lasted almost 30 days in median in critically ill patients, and the viral load in the LRT was associated with the 6-week mortality.

【 授权许可】

CC BY