Viral dynamics in mild and severe cases of COVID-19

• Published in: The Lancet infectious diseases Vol. 20; no. 6; pp. 656 - 657
• Main Authors: Liu, Yang, Yan, Li-Meng, Wan, Lagen, Xiang, Tian-Xin, Le, Aiping, Liu, Jia-Ming, Peiris, Malik, Poon, Leo L M, Zhang, Wei
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.06.2020; Elsevier Limited
• Subjects: Adult; Aged; Betacoronavirus - pathogenicity; Betacoronavirus - physiology; Blood pressure; China; Coronavirus Infections - diagnosis; Coronavirus Infections - virology; Coronaviruses; COVID-19; Female; Health services; Humans; Infectious diseases; Male; Mechanical ventilation; Middle Aged; Oxygen; Oxygen content; Pandemics; Partial pressure; Patients; Pneumonia, Viral - diagnosis; Pneumonia, Viral - virology; Respiratory organs; RNA, Viral - isolation & purification; SARS-CoV-2; Septic shock; Severe acute respiratory syndrome coronavirus 2; Viral Load; Virus Shedding; China
• ISSN: 1473-3099; 1474-4457; 1474-4457
• DOI: 10.1016/S1473-3099(20)30232-2

Patients who had any of the following features at the time of, or after, admission were classified as severe cases: (1) respiratory distress (≥30 breaths per min); (2) oxygen saturation at rest ≤93%; (3) ratio of partial pressure of arterial oxygen to fractional concentration of oxygen inspired air ≤300 mm Hg; or (4) severe disease complications (eg, respiratory failure, requirement of mechanical ventilation, septic shock, or non-respiratory organ failure). Parameters did not differ significantly between the groups, except that patients in the severe group were significantly older than those in the mild group, as expected.4 No patient died from the infection. 23 (77%) of 30 severe cases received intensive care unit (ICU) treatment, whereas none of the mild cases required ICU treatment. All samples were collected according to WHO guidelines.5 The mean viral load of severe cases was around 60 times higher than that of mild cases, suggesting that higher viral loads might be associated with severe clinical outcomes.