SARS-CoV-2 viral load is associated with increased disease severity and mortality

Jesse Fajnzylber, James Regan, Kendyll Coxen, Heather Corry, Colline Wong, Alexandra Rosenthal, Daniel Worrall, Francoise Giguel, Alicja Piechocka-Trocha, Caroline Atyeo, Stephanie Fischinger, Andrew Chan, Keith T. Flaherty, Kathryn Hall, Michael Dougan, Edward T. Ryan, Elizabeth Gillespie, Rida Chishti, Yijia Li, Nikolaus Jilg, Dusan Hanidziar, Rebecca M. Baron, Lindsey Baden, Athe M. Tsibris, Katrina A. Armstrong, Daniel R. Kuritzkes, Galit Alter, Bruce D. Walker, Xu Yu and Jonathan Z. Li ()
Additional contact information
Jesse Fajnzylber: Brigham and Women’s Hospital, Harvard Medical School
James Regan: Brigham and Women’s Hospital, Harvard Medical School
Kendyll Coxen: Brigham and Women’s Hospital, Harvard Medical School
Heather Corry: Brigham and Women’s Hospital, Harvard Medical School
Colline Wong: Brigham and Women’s Hospital, Harvard Medical School
Alexandra Rosenthal: Brigham and Women’s Hospital, Harvard Medical School
Daniel Worrall: Ragon Institute of MGH, MIT and Harvard, Harvard Medical School
Francoise Giguel: Massachusetts General Hospital, Harvard Medical School
Alicja Piechocka-Trocha: Ragon Institute of MGH, MIT and Harvard, Harvard Medical School
Caroline Atyeo: Ragon Institute of MGH, MIT and Harvard, Harvard Medical School
Stephanie Fischinger: Ragon Institute of MGH, MIT and Harvard, Harvard Medical School
Andrew Chan: Massachusetts General Hospital, Harvard Medical School
Keith T. Flaherty: Massachusetts General Hospital, Harvard Medical School
Kathryn Hall: Massachusetts General Hospital, Harvard Medical School
Michael Dougan: Massachusetts General Hospital, Harvard Medical School
Edward T. Ryan: Massachusetts General Hospital, Harvard Medical School
Elizabeth Gillespie: Brigham and Women’s Hospital, Harvard Medical School
Rida Chishti: Brigham and Women’s Hospital, Harvard Medical School
Yijia Li: Brigham and Women’s Hospital, Harvard Medical School
Nikolaus Jilg: Brigham and Women’s Hospital, Harvard Medical School
Dusan Hanidziar: Massachusetts General Hospital, Harvard Medical School
Rebecca M. Baron: Brigham and Women’s Hospital, Harvard Medical School
Lindsey Baden: Brigham and Women’s Hospital, Harvard Medical School
Athe M. Tsibris: Brigham and Women’s Hospital, Harvard Medical School
Katrina A. Armstrong: Massachusetts General Hospital, Harvard Medical School
Daniel R. Kuritzkes: Brigham and Women’s Hospital, Harvard Medical School
Galit Alter: Ragon Institute of MGH, MIT and Harvard, Harvard Medical School
Bruce D. Walker: Ragon Institute of MGH, MIT and Harvard, Harvard Medical School
Xu Yu: Ragon Institute of MGH, MIT and Harvard, Harvard Medical School
Jonathan Z. Li: Brigham and Women’s Hospital, Harvard Medical School

Nature Communications, 2020, vol. 11, issue 1, 1-9

Abstract: Abstract The relationship between SARS-CoV-2 viral load and risk of disease progression remains largely undefined in coronavirus disease 2019 (COVID-19). Here, we quantify SARS-CoV-2 viral load from participants with a diverse range of COVID-19 disease severity, including those requiring hospitalization, outpatients with mild disease, and individuals with resolved infection. We detected SARS-CoV-2 plasma RNA in 27% of hospitalized participants, and 13% of outpatients diagnosed with COVID-19. Amongst the participants hospitalized with COVID-19, we report that a higher prevalence of detectable SARS-CoV-2 plasma viral load is associated with worse respiratory disease severity, lower absolute lymphocyte counts, and increased markers of inflammation, including C-reactive protein and IL-6. SARS-CoV-2 viral loads, especially plasma viremia, are associated with increased risk of mortality. Our data show that SARS-CoV-2 viral loads may aid in the risk stratification of patients with COVID-19, and therefore its role in disease pathogenesis should be further explored.

Date: 2020
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DOI: 10.1038/s41467-020-19057-5

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