Dataset Information

SARS-CoV-2 detection in the lower respiratory tract of invasively ventilated ARDS patients.

ABSTRACT:

Background

Data on SARS-CoV-2 load in lower respiratory tract (LRT) are scarce. Our objectives were to describe the viral shedding and the viral load in LRT and to determine their association with mortality in critically ill COVID-19 patients.

Methods

We conducted a binational study merging prospectively collected data from two COVID-19 reference centers in France and Switzerland. First, we described the viral shedding duration (i.e., time to negativity) in LRT samples. Second, we analyzed viral load in LRT samples. Third, we assessed the association between viral presence in LRT and mortality using mixed-effect logistic models for clustered data adjusting for the time between symptoms' onset and date of sampling.

Results

From March to May 2020, 267 LRT samples were performed in 90 patients from both centers. The median time to negativity was 29 (IQR 23; 34) days. Prolonged viral shedding was not associated with age, gender, cardiac comorbidities, diabetes, immunosuppression, corticosteroids use, or antiviral therapy. The LRT viral load tended to be higher in non-survivors. This difference was statistically significant after adjusting for the time interval between onset of symptoms and date of sampling (OR 3.78, 95% CI 1.13-12.64, p?=?0.03).

Conclusions

The viral shedding in LRT lasted almost 30?days in median in critically ill patients, and the viral load in the LRT was associated with the 6-week mortality.

SUBMITTER: Buetti N

PROVIDER: S-EPMC7562762 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

SARS-CoV-2 detection in the lower respiratory tract of invasively ventilated ARDS patients.

Buetti Niccolò N Wicky Paul-Henri PH Le Hingrat Quentin Q Ruckly Stéphane S Mazzuchelli Timothy T Loiodice Ambre A Trimboli Pierpaolo P Forni Ogna Valentina V de Montmollin Etienne E Bernasconi Enos E Visseaux Benoit B Timsit Jean-François JF

Critical care (London, England) 20201016 1

<h4>Background</h4>Data on SARS-CoV-2 load in lower respiratory tract (LRT) are scarce. Our objectives were to describe the viral shedding and the viral load in LRT and to determine their association with mortality in critically ill COVID-19 patients.<h4>Methods</h4>We conducted a binational study merging prospectively collected data from two COVID-19 reference centers in France and Switzerland. First, we described the viral shedding duration (i.e., time to negativity) in LRT samples. Second, we ...[more]

PMID: 33066801

Similar Datasets

Project description:BackgroundLung ultrasound (LUS) can detect pulmonary edema and it is under consideration to be added to updated acute respiratory distress syndrome (ARDS) criteria. However, it remains uncertain whether different LUS scores can be used to quantify pulmonary edema in patient with ARDS.ObjectivesThis study examined the diagnostic accuracy of four LUS scores with the extravascular lung water index (EVLWi) assessed by transpulmonary thermodilution in patients with moderate-to-severe COVID-19 ARDS.MethodsIn this predefined secondary analysis of a multicenter randomized-controlled trial (InventCOVID), patients were enrolled within 48 hours after intubation and underwent LUS and EVLWi measurement on the first and fourth day after enrolment. EVLWi and ∆EVLWi were used as reference standards. Two 12-region scores (global LUS and LUS-ARDS), an 8-region anterior-lateral score and a 4-region B-line score were used as index tests. Pearson correlation was performed and the area under the receiver operating characteristics curve (AUROCC) for severe pulmonary edema (EVLWi > 15 mL/kg) was calculated.Results26 out of 30 patients (87%) had complete LUS and EVLWi measurements at time point 1 and 24 out of 29 patients (83%) at time point 2. The global LUS (r = 0.54), LUS-ARDS (r = 0.58) and anterior-lateral score (r = 0.54) correlated significantly with EVLWi, while the B-line score did not (r = 0.32). ∆global LUS (r = 0.49) and ∆anterior-lateral LUS (r = 0.52) correlated significantly with ∆EVLWi. AUROCC for EVLWi > 15 ml/kg was 0.73 for the global LUS, 0.79 for the anterior-lateral and 0.85 for the LUS-ARDS score.ConclusionsOverall, LUS demonstrated an acceptable diagnostic accuracy for detection of pulmonary edema in moderate-to-severe COVID-19 ARDS when compared with PICCO. For identifying patients at risk of severe pulmonary edema, an extended score considering pleural morphology may be of added value.Trial registrationClinicalTrials.gov identifier NCT04794088, registered on 11 March 2021. European Clinical Trials Database number 2020-005447-23.

Dataset Information

SARS-CoV-2 detection in the lower respiratory tract of invasively ventilated ARDS patients.

Background

Methods

Results

Conclusions

Publications

SARS-CoV-2 detection in the lower respiratory tract of invasively ventilated ARDS patients.

Similar Datasets

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