“Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load
Abstract Introduction The relationship between SARS-CoV-2 viral load and hospitalization and mortality among COVID-19 patients has been established. However, the estimation of the duration of time after which the risk of mortality of these patients stops escalating was not extensively discussed earl...
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ftdoajarticles:oai:doaj.org/article:c792b0b849994b638f2b43d109dd3e1e 2023-05-15T15:17:15+02:00 “Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load Nancy A. Osman Mona H. Hashish Wafaa M. K. Bakr Nermin A. Osman Eman A. Omran 2022-12-01T00:00:00Z https://doi.org/10.1186/s41182-022-00483-8 https://doaj.org/article/c792b0b849994b638f2b43d109dd3e1e EN eng BMC https://doi.org/10.1186/s41182-022-00483-8 https://doaj.org/toc/1349-4147 doi:10.1186/s41182-022-00483-8 1349-4147 https://doaj.org/article/c792b0b849994b638f2b43d109dd3e1e Tropical Medicine and Health, Vol 50, Iss 1, Pp 1-11 (2022) Cycle threshold Cumulative mortality COVID-19 CO-RAD Predictors of mortality Arctic medicine. Tropical medicine RC955-962 article 2022 ftdoajarticles https://doi.org/10.1186/s41182-022-00483-8 2022-12-30T20:12:07Z Abstract Introduction The relationship between SARS-CoV-2 viral load and hospitalization and mortality among COVID-19 patients has been established. However, the estimation of the duration of time after which the risk of mortality of these patients stops escalating was not extensively discussed earlier. Stratifying patients according to their risk of mortality would optimize healthcare services and costs and reduce mortality. Methodology In this retrospective observational study, hospital records were used to collect data of 519 COVID-19 patients from May through November 2020. Data included the clinical condition of patients, their viral loads, their admission chest computed tomography results (CO-RAD scale), and the duration of their hospitalization. A Kaplan–Meier analysis was constructed to estimate mortality risk concerning viral load. Results By the end of the study, 20.42% of patients were deceased. The cumulative mortality was: 36.1% (75/208) among patients with high viral load, 12.6% (28/222) in those with moderate viral load, and 3.4% (3/89) among those with low viral load. Predictors of mortality were: older age [adjusted hazard ratio (aHR) = 1.02, 95% CI: [1.00–1.03], (p = 0.05)], "being female" [aHR = 1.53 with 95% CI: [1.03–2.26], (p = 0.031), "high CO-RAD scale" [aHR = 1.32 (1.06–1.64), p = 0.013], "high viral load" [aHR = 4.59 (2.38–20.92), p = 0.017, ICU admission [aHR = 15.95; 95%CI:7.22–35.20, p < 0.001] and lymphocytosis [aHR = 1.89 45;95%CI:1.04–3.45, p = 0.036]. In the ICU-admitted patients, the median survival was 19 days and mortality stabilized at "day 25". For patients with high viral load, mortality rates stabilized at "day 25 post-admission" after which the risks of mortality did not change until day 40, while patients with low and moderate viral loads reached the peak and stabilized at day "20 post-admission". Conclusions Initial high SARS-CoV-2 viral load might be used as an indicator of a delayed stabilization of mortality risk among COVID-19 patients. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) Tropical Medicine and Health 50 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Cycle threshold Cumulative mortality COVID-19 CO-RAD Predictors of mortality Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Cycle threshold Cumulative mortality COVID-19 CO-RAD Predictors of mortality Arctic medicine. Tropical medicine RC955-962 Nancy A. Osman Mona H. Hashish Wafaa M. K. Bakr Nermin A. Osman Eman A. Omran “Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load |
topic_facet |
Cycle threshold Cumulative mortality COVID-19 CO-RAD Predictors of mortality Arctic medicine. Tropical medicine RC955-962 |
description |
Abstract Introduction The relationship between SARS-CoV-2 viral load and hospitalization and mortality among COVID-19 patients has been established. However, the estimation of the duration of time after which the risk of mortality of these patients stops escalating was not extensively discussed earlier. Stratifying patients according to their risk of mortality would optimize healthcare services and costs and reduce mortality. Methodology In this retrospective observational study, hospital records were used to collect data of 519 COVID-19 patients from May through November 2020. Data included the clinical condition of patients, their viral loads, their admission chest computed tomography results (CO-RAD scale), and the duration of their hospitalization. A Kaplan–Meier analysis was constructed to estimate mortality risk concerning viral load. Results By the end of the study, 20.42% of patients were deceased. The cumulative mortality was: 36.1% (75/208) among patients with high viral load, 12.6% (28/222) in those with moderate viral load, and 3.4% (3/89) among those with low viral load. Predictors of mortality were: older age [adjusted hazard ratio (aHR) = 1.02, 95% CI: [1.00–1.03], (p = 0.05)], "being female" [aHR = 1.53 with 95% CI: [1.03–2.26], (p = 0.031), "high CO-RAD scale" [aHR = 1.32 (1.06–1.64), p = 0.013], "high viral load" [aHR = 4.59 (2.38–20.92), p = 0.017, ICU admission [aHR = 15.95; 95%CI:7.22–35.20, p < 0.001] and lymphocytosis [aHR = 1.89 45;95%CI:1.04–3.45, p = 0.036]. In the ICU-admitted patients, the median survival was 19 days and mortality stabilized at "day 25". For patients with high viral load, mortality rates stabilized at "day 25 post-admission" after which the risks of mortality did not change until day 40, while patients with low and moderate viral loads reached the peak and stabilized at day "20 post-admission". Conclusions Initial high SARS-CoV-2 viral load might be used as an indicator of a delayed stabilization of mortality risk among COVID-19 patients. |
format |
Article in Journal/Newspaper |
author |
Nancy A. Osman Mona H. Hashish Wafaa M. K. Bakr Nermin A. Osman Eman A. Omran |
author_facet |
Nancy A. Osman Mona H. Hashish Wafaa M. K. Bakr Nermin A. Osman Eman A. Omran |
author_sort |
Nancy A. Osman |
title |
“Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load |
title_short |
“Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load |
title_full |
“Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load |
title_fullStr |
“Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load |
title_full_unstemmed |
“Day 25”: a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load |
title_sort |
“day 25”: a temporal indicator of stabilization of mortality risk among covid-19 patients with high viral load |
publisher |
BMC |
publishDate |
2022 |
url |
https://doi.org/10.1186/s41182-022-00483-8 https://doaj.org/article/c792b0b849994b638f2b43d109dd3e1e |
long_lat |
ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
geographic |
Arctic Meier |
geographic_facet |
Arctic Meier |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Tropical Medicine and Health, Vol 50, Iss 1, Pp 1-11 (2022) |
op_relation |
https://doi.org/10.1186/s41182-022-00483-8 https://doaj.org/toc/1349-4147 doi:10.1186/s41182-022-00483-8 1349-4147 https://doaj.org/article/c792b0b849994b638f2b43d109dd3e1e |
op_doi |
https://doi.org/10.1186/s41182-022-00483-8 |
container_title |
Tropical Medicine and Health |
container_volume |
50 |
container_issue |
1 |
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1766347510316531712 |