The National Health Service of the United Kingdom published for the October 2021 edition of the Journal of Infection, SARS-CoV-2 viral load at presentation to hospital is independently associated with the risk of death.
The study evaluated whether viral loads, age, duration of illness, and antibody levels against the SARS-CoV-2 are determinants of mortality.
They found that the viral load at the time of presentation to the hospital is the best indicator of mortality.
The presence of SARS-CoV-2 in a typical nasal swab is tested with the reverse-transcriptase polymerase chain reaction (RT-PCR).
Quantification of the viral load is dependent on the cycle threshold of the RT-PCR.
Cycle threshold refers to the number of cycles needed for a sample
to amplify and cross a threshold (cut-off) to be considered detected/positive.
According to Public Health England,
Cycle threshold (Ct) is a semi-quantitative value that can broadly categorise the concentration of viral genetic material in a patient sample following testing by RT PCR as low, medium or high – that is, it tells us approximately how much viral genetic material is in the sample.
A low Ct indicates a high concentration of viral genetic material, which is typically associated with high risk of infectivity.
A high Ct indicates a low concentration of viral genetic material which is typically associated with a lower risk of infectivity.
The study showed using multivariate analysis that low Ct values (high viral load) at admission were associated with higher in-hospital mortality.
Older age and cardiovascular disease and diabetes, higher creatinine levels, and NEWS2 scores were also associated with higher hospital mortality.
The NEWS2 score is based on the patient’s vital signs, consciousness, and presence of COVID-19. Vital signs are put in the NEWS2 calculator, and the resulting value gives an idea of how sick the patient is.
Older age is an indicator of admission to the ICU but not hospital death. The reason is that older adults are more likely to be admitted to the ICU since they are frailer.
Overall, the viral load is the best predictor of hospital deaths among COVID-19 patients. The lower the CT value, the higher the viral load, the higher chance of dying.
What’s the use of the study?
Knowing the viral load on admission by Ct values and clinical judgment can identify who will most likely have a severe COVID-19 and direct treatment. Hospitals do not have unlimited ICU beds.
How do you avoid high SARS-CoV-2 loads?
Early diagnosis and treatment of COVID-19 are keys to lowering loads.
Known exposure to anyone symptomatic of COVID-19 with early signs like loss of smell, taste and sore throat, muscle aches, and chills should prompt early testing and physician consultation.
Early treatment protocols like the I-MASK+ Prevention and Early Treatment Protocol from the FLCCC have been proven effective by many.
A high viral load can lead to a hyper autoimmune response that leads to multi-system organ failure and death.
Early treatment leads to shorter symptom duration, higher survival, and the development of a durable and robust immune system.
Read: Harvard: Immunity from mild COVID-19 infection much better than vaccination and Asymptomatic or mild symptomatic COVID-19 elicits effective and long-lasting antibody responses in children and adolescents
The vaccinated and unvaccinated are still susceptible to the SARS-CoV-2 variants. COVID-19 treatment can be started at home. Don’t wait to be hospitalized to start treatment.
Knowledge about Covid-19 is rapidly evolving. Information may update as new studies are made. Stay current by subscribing. Feel free to share and like.
Don’t Get Sick!
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Reference: Tanner AR, Phan H, Brendish NJ, et al. SARS-CoV-2 viral load at presentation to hospital is independently associated with the risk of death. J Infect. 2021;83(4):458-466. doi:10.1016/j.jinf.2021.08.003
Image Credit: Nasopharyngeal swab. By cdc.gov – https://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html, Public Domain, https://commons.wikimedia.org/w/index.php?curid=38360525
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