Your browser doesn't support javascript.
Dynamics of SARS-CoV-2 shedding in the respiratory tract depends on the severity of disease in COVID-19 patients.
Munker, Dieter; Osterman, Andreas; Stubbe, Hans; Muenchhoff, Maximilian; Veit, Tobias; Weinberger, Tobias; Barnikel, Michaela; Mumm, Jan-Niclas; Milger, Katrin; Khatamzas, Elham; Klauss, Sarah; Scherer, Clemens; Hellmuth, Johannes C; Giessen-Jung, Clemens; Zoller, Michael; Herold, Tobias; Stecher, Stephanie; de Toni, Enrico N; Schulz, Christian; Kneidinger, Nikolaus; Keppler, Oliver T; Behr, Jürgen; Mayerle, Julia; Munker, Stefan.
  • Munker D; Dept of Medicine 5, University Hospital, Ludwig Maximilian University of Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany.
  • Osterman A; These authors contributed equally to this work.
  • Stubbe H; Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Ludwig Maximilian University, Munich, Germany.
  • Muenchhoff M; German Center for Infection Research, Partner Site Munich and Associated Partner Site Munich, Munich, Germany.
  • Veit T; These authors contributed equally to this work.
  • Weinberger T; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Barnikel M; Dept of Medicine 2, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Mumm JN; Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Ludwig Maximilian University, Munich, Germany.
  • Milger K; German Center for Infection Research, Partner Site Munich and Associated Partner Site Munich, Munich, Germany.
  • Khatamzas E; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Klauss S; Dept of Medicine 5, University Hospital, Ludwig Maximilian University of Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany.
  • Scherer C; Emergency Dept, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Hellmuth JC; Dept of Medicine 1, Ludwig Maximilian University of Munich, Munich, Germany.
  • Giessen-Jung C; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.
  • Zoller M; Dept of Medicine 5, University Hospital, Ludwig Maximilian University of Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany.
  • Herold T; Dept of Urology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Stecher S; Dept of Medicine 5, University Hospital, Ludwig Maximilian University of Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich, Munich, Germany.
  • de Toni EN; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Schulz C; Dept of Medicine 3, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Kneidinger N; Dept of Medicine 2, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Keppler OT; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Behr J; Emergency Dept, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • Mayerle J; Dept of Medicine 1, Ludwig Maximilian University of Munich, Munich, Germany.
  • Munker S; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.
Eur Respir J ; 58(1)2021 Jul.
Article in English | MEDLINE | ID: covidwho-1105685
ABSTRACT
A fraction of COVID-19 patients progress to a severe disease manifestation with respiratory failure and the necessity of mechanical ventilation. Identifying patients at risk is critical for optimised care and early therapeutic interventions. We investigated the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding relative to disease severity.We analysed nasopharyngeal and tracheal shedding of SARS-CoV-2 in 92 patients with diagnosed COVID-19. Upon admission, standardised nasopharyngeal swab or sputum samples were collected. If patients were mechanically ventilated, endotracheal aspirate samples were additionally obtained. Viral shedding was quantified by real-time PCR detection of SARS-CoV-2 RNA.45% (41 out of 92) of COVID-19 patients had a severe disease course with the need for mechanical ventilation (severe group). At week 1, the initial viral shedding determined from nasopharyngeal swabs showed no significant difference between nonsevere and severe cases. At week 2, a difference could be observed as the viral shedding remained elevated in severely ill patients. A time-course of C-reactive protein, interleukin-6 and procalcitonin revealed an even more protracted inflammatory response following the delayed drop of virus shedding load in severely ill patients. A significant proportion (47.8%) of patients showed evidence of prolonged viral shedding (>17 days), which was associated with severe disease courses (73.2%).We report that viral shedding does not differ significantly between severe and nonsevere COVID-19 cases upon admission to the hospital. Elevated SARS-CoV-2 shedding in the second week of hospitalisation, a systemic inflammatory reaction peaking between the second and third week, and prolonged viral shedding are associated with a more severe disease course.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: SARS-CoV-2 / COVID-19 Subject: SARS-CoV-2 / COVID-19 Language: English Clinical aspect: Etiology / Prognosis Year: 2021

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: SARS-CoV-2 / COVID-19 Subject: SARS-CoV-2 / COVID-19 Language: English Clinical aspect: Etiology / Prognosis Year: 2021
...