@article{3102581,
    title = "Association between Upper Respiratory Tract Viral Load, Comorbidities, Disease Severity, and Outcome of Patients with SARS-CoV-2 Infection",
    author = "Maltezou, H.C. and Raftopoulos, V. and Vorou, R. and Papadima, K. and Mellou, K. and Spanakis, N. and Kossyvakis, A. and Gioula, G. and Exindari, M. and Froukala, E. and Martinez-Gonzalez, B. and Panayiotakopoulos, G. and Papa, A. and Mentis, A. and Tsakris, A.",
    journal = "JOURNAL OF INFECTIOUS DISEASES",
    year = "2021",
    volume = "223",
    number = "7",
    pages = "1132-1138",
    publisher = "Oxford University Press",
    issn = "0022-1899",
    doi = "10.1093/infdis/jiaa804",
    keywords = "adult;  age;  aged;  Article;  asymptomatic coronavirus disease 2019;  cardiovascular disease;  chronic disease;  chronic lung disease;  clinical outcome;  comorbidity;  comparative study;  coronavirus disease 2019;  cycle threshold value;  death;  disease severity;  female;  human;  hypertension;  immune deficiency;  intensive care unit;  intubation;  length of stay;  major clinical study;  male;  morbidity;  multivariate analysis;  neurologic disease;  obesity;  polymerase chain reaction;  risk assessment;  Severe acute respiratory syndrome coronavirus 2;  univariate analysis;  upper respiratory tract;  virus load;  adolescent;  artificial ventilation;  child;  comorbidity;  diagnosis;  endotracheal intubation;  infant;  isolation and purification;  middle aged;  mortality;  nasopharynx;  newborn;  oropharynx;  preschool child;  prospective study;  severity of illness index;  therapy;  very elderly;  virology;  virus load;  young adult, Adolescent;  Adult;  Aged;  Aged, 80 and over;  Child;  Child, Preschool;  Comorbidity;  COVID-19;  COVID-19 Nucleic Acid Testing;  Female;  Humans;  Infant;  Infant, Newborn;  Intensive Care Units;  Intubation, Intratracheal;  Length of Stay;  Male;  Middle Aged;  Nasopharynx;  Oropharynx;  Prospective Studies;  Respiration, Artificial;  SARS-CoV-2;  Severity of Illness Index;  Viral Load;  Young Adult",
    abstract = "Background: There is limited information on the association between upper respiratory tract (URT) viral loads, host factors, and disease severity in SARS-CoV-2-infected patients. Methods: We studied 1122 patients (mean age, 46 years) diagnosed by polymerase chain reaction (PCR). URT viral load, measured by PCR cycle threshold, was categorized as high, moderate, or low. Results: There were 336 (29.9%) patients with comorbidities; 309 patients (27.5%) had high, 316 (28.2%) moderate, and 497 (44.3%) low viral load. In univariate analyses, compared to patients with moderate or low viral load, patients with high viral load were older, more often had comorbidities, developed Symptomatic disease (COVID-19), were intubated, and died. Patients with high viral load had longer stay in intensive care unit and longer intubation compared to patients with low viral load (P values†<†.05 for all comparisons). Patients with chronic cardiovascular disease, hypertension, chronic pulmonary disease, immunosuppression, obesity, and chronic neurological disease more often had high viral load (P value†<†.05 for all comparisons). In multivariate analysis high viral load was associated with COVID-19. Level of viral load was not associated with any other outcome. Conclusions: URT viral load could be used to identify patients at higher risk for morbidity or severe outcome. © 2021 The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com."
}