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Impact of baseline SARS-CoV-2 load in plasma and upper airways on the incidence of acute extrapulmonary complications of COVID-19: a multicentric, prospective, cohort study

  1. Author:
    Jensen, Tomas O [ORCID]
    Harper, Katrina
    Gupta, Shaili
    Liu, Sean T
    Dharan, Nila J
    Baker, Jason V
    Pett, Sarah L
    Shaw-Saliba, Kathryn
    Esmail, Aliasgar [ORCID]
    Ho, Minh Q
    Almasri, Eyad
    Dewar,Robin
    Lundgren, Jens [ORCID]
    Vock, David M

  2. Author Address

    Centre of Excellence for Health, Immunity, and Infections, Rigshospitalet, University of Copenhagen, Denmark., Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN, USA., Department of Medicine, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA., Department of Medicine, Yale School of Medicine, New Haven, CT, USA., Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA., Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia., Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, USA., Division of Infectious Diseases, Hennepin Healthcare, Minneapolis, MN, USA., The Medical Research Council Clinical Trials Unit at UCL, University College London, London, United Kingdom., National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA., Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa., Department of Infectious Diseases, Orlando VA Medical Center, Orlando, FL, USA., Department of pulmonology, University of California San Francisco, Fresno, CA, USA., Frederick National Laboratory for Cancer Research, Frederick, MD, USA.,
    1. Year: 2024
    2. Date: Sep 13
    3. Epub Date: 2024 09 13
  2. Journal: Clinical Infectious Diseases : an official publication of the Infectious Diseases Society of America
  4. Type of Article: Article
  5. Article Number: ciae469
  1. Abstract:

    Extrapulmonary complications (EPCs) are common in patients hospitalized for COVID-19, but data on their clinical consequences and association with viral replication and systemic viral dissemination is lacking. Patients hospitalized for COVID-19 and enrolled in the TICO (Therapeutics for Inpatients with COVID-19) platform trial at 114 international sites between August 2020 and November 2021 were included in a prospective cohort study. We categorized EPCs into 39 event types within 9 categories and estimated their frequency through day 28 and their association with clinical outcomes through day 90. We analyzed the association between baseline viral burden (plasma nucleocapsid antigen [N-Ag] and upper airway viral load [VL]) and EPCs, adjusting for other baseline factors. 2,625 trial participants were included in the study. The median age was 57 years (IQR 46-68), 57.7% were male, and 537 (20.5%) had at least one EPC. EPCs were associated with higher day-90 all-cause mortality (HR 9.6, 95% CI 7.3, 12.7) after adjustment for other risk factors. The risk of EPCs increased with increasing baseline plasma N-Ag (HR 1.21 per log10 ng/L increase, 95% CI 1.09, 1.34), and upper airway VL (HR 1.12 per log10 copies/mL increase, 95% CI 1.04, 1.19), after adjusting for comorbidities, disease severity, inflammatory markers, and other baseline factors. Trial treatment allocation had no effect on EPC risk. Systemic viral dissemination as evidenced by high plasma N-Ag and high respiratory viral burden are associated with development of EPCs in COVID-19, which in turn are associated with higher 90-day mortality. © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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External Sources

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  2. DOI: 10.1093/cid/ciae469
  3. PMID: 39271151
  4. PII : 7756713

Library Notes

  1. Fiscal Year: FY2024-2025
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