SARS-CoV-2 Viral Load Predicts Mortality in Patients with and Without Cancer Who are Hospitalized with Coronavirus Disease 2019
43 Pages Posted: 3 Sep 2020 Publication Status: PublishedMore...
Patients with cancer may be at increased risk of severe coronavirus disease 2019 (COVID-19), but the role of viral load on this risk is unknown. We measured SARS-CoV-2 viral load using cycle threshold (CT) values from reverse transcription-polymerase chain reaction assays applied to nasopharyngeal swab specimens in 100 patients with cancer and 2914 without cancer admitted to three New York City hospitals. Overall, the in-hospital mortality rate was 39.5% among patients with a high viral load (CT<25), 25.6% among patients with a medium viral load (CT 25-30), and 15.7% among patients with a low viral load (CT>30; P<0.001). Similar findings were observed in patients with cancer (high, 45.0% mortality; medium, 29.2%; low, 13.9%; P=0.003). Patients with hematologic malignancies had higher median viral loads (CT=25.0) than patients without cancer (CT=29.2; P=0.0039). SARS-CoV-2 viral load results may offer vital prognostic information for patients with and without cancer who are hospitalied with COVID-19.
Funding: This work was partially supported by the National Centerfor Advancing Translational Science [UL1 TR002384 to Julianne Imperato-McGinley] at the National Institutes of Health.
Conflict of Interest: L.F.W. reports receiving consulting fees from Roche Molecular Systems, Inc. M.M.S. receives grant support from Amgen, Inc. All other authors report no potential conflicts of interest.
Ethical Approval Statement: The study was approved by the Institutional Review Board (#20-03021681) at Weill Cornell Medicine with a waiver of informed consent
Keywords: cancer, coronavirus disease 2019 (COVID-19), cycle threshold (CT), hematologic malignancy, mortality, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), solid tumor, viral load
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