The COVID-19 viral load at ICU admission determines patient prognosis
One in three patients in the study had a “viral storm”, showing signs of an increased inflammatory response
A new study reveals the importance of the ‘viral storm’ in critical patients with COVID-19. The study has been published in The Lancet Microbe and conducted by several groups in the area of respiratory diseases (CIBERES) and the area of infectious diseases (CIBERINFEC) at the CIBER, a consortium from the Institute of Health Carlos III (ISCIII). The results show that the viral load at ICU admission is a factor that determines the prognosis of critical patients with COVID-19.
The CIBER researchers who led the study – part of the CIBERESUCICOVID project of the COVID Fund – Instituto de Salud Carlos III – Antoni Torres, Ferrán Barbé, Jesús Bermejo, Anna Motos and Salvador Resino, together with Nadia García-Mateo (IBSAL) and David J. Kelvin of Dalhousie University (Canada), observed that the higher the plasma viral RNA load in patients with COVID-19 on admission to the ICU, the higher the risk of mortality.
The territorial clinical director of chronic respiratory diseases, professor at the University of Lleida and head of the Translational Research in Respiratory Medicine group, Ferrán Barbé, scientific director of CIBERES, says it will be important “to study what impact this viral storm has on the long-term consequences of the disease in critical patients who survived the virus”.
Specifically, a group of patients were identified who presented a ‘viral storm’, characterised by the massive release of SARS-CoV-2 ribonucleic acid (RNA) and proteins in the blood, and who, on admission to the ICU, had not produced sufficient antibodies against the S protein of the virus, showing signs of an increased inflammatory response. This group represents one-third of the 836 critically ill patients with COVID-19 from a cohort recruited during the first year of the pandemic in 23 ICUs across the country. Not only did they have the highest mortality rate (half died within 90 days of admission), but they also had significant complications: 94% required invasive mechanical ventilation, 41% suffered acute renal failure and 65% developed secondary infections.
Thus, it is shown that patients with COVID-19 who are unable to control the virus have the worst prognosis, and that the inflammatory response in these patients is directly related to the intensity of viral replication. It is revealed that the key to preventing complications of COVID-19 in patients with risk factors lies in early control of the virus, a fundamental principle that could be applied not only to future pandemics caused by emerging viruses, but also to viruses responsible for seasonal epidemics.
More information: https://www.irblleida.org/en/news/1484/the-covid-19-viral-load-at-icu-admission-determines-patient-prognosis
