Changes in SARS-CoV-2 viral load and mortality during the initial wave of the pandemic in New York City.

TitleChanges in SARS-CoV-2 viral load and mortality during the initial wave of the pandemic in New York City.
Publication TypeJournal Article
Year of Publication2021
AuthorsSatlin MJ, Zucker J, Baer BR, Rajan M, Hupert N, Schang LM, Pinheiro LC, Shen Y, Sobieszczyk ME, Westblade LF, Goyal P, Wells MT, Sepulveda JL, Safford MM
JournalPLoS One
Date Published2021

Public health interventions such as social distancing and mask wearing decrease the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but it is unclear whether they decrease the viral load of infected patients and whether changes in viral load impact mortality from coronavirus disease 2019 (COVID-19). We evaluated 6923 patients with COVID-19 at six New York City hospitals from March 15-May 14, 2020, corresponding with the implementation of public health interventions in March. We assessed changes in cycle threshold (CT) values from reverse transcription-polymerase chain reaction tests and in-hospital mortality and modeled the impact of viral load on mortality. Mean CT values increased between March and May, with the proportion of patients with high viral load decreasing from 47.7% to 7.8%. In-hospital mortality increased from 14.9% in March to 28.4% in early April, and then decreased to 8.7% by May. Patients with high viral loads had increased mortality compared to those with low viral loads (adjusted odds ratio 2.34). If viral load had not declined, an estimated 69 additional deaths would have occurred (5.8% higher mortality). SARS-CoV-2 viral load steadily declined among hospitalized patients in the setting of public health interventions, and this correlated with decreases in mortality.

Alternate JournalPLoS One
PubMed ID34797838
PubMed Central IDPMC8604305
Related Faculty: 
Lars Westblade, Ph.D.


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