Higher viral load more deadly for COVID-19 hospital patients, UW analysis finds

This has nothing to do with politics, but it is useful information that those of you who do not read The Seattle Times may not be aware of. By the way great to be “back in the Saddle” and still sane!

By Sandi Doughton Seattle Times staff reporter

COVID-19 patients who have high levels of coronavirus in their bodies when admitted to the hospital are four times more likely to die than those with lower amounts of virus, according to a new analysis from the University of Washington.

But viral loads, which could help identify patients most at risk, are not generally measured or reported for COVID-19, says the report published this week in the journal Open Forum Infectious Disease.

“I would like to see it more routinely used,” said Dr. Alex Greninger, assistant director of the UW Medicine Clinical Virology Laboratory, which conducts much of the coronavirus testing for the state. “Unfortunately, we haven’t had this information for most of the pandemic.”

Measuring viral levels might also help contact tracers identify and focus on the most infectious people, said Dr. Andrew Bryan, medical director of the clinical laboratory at UW Medicine – Northwest and lead author of the analysis.

The UW study adds to growing evidence that high amounts of the novel coronavirus translate into more serious illness, which is true for many viral infections.

“These differences are not subtle,” Greninger said. One recent sample analyzed at the lab had a level of virus 100 million times higher than the test’s detection threshold.

But diagnostic tests for novel coronavirus are only approved by the U.S. Food and Drug Administration (FDA) to give “positive,” or “negative,” answers — not to measure viral loads, Greninger said. An FDA spokesperson confirmed in an email, “there are currently no authorized quantitative molecular tests for COVID-19.”

The type of test used at the UW, considered the gold standard for diagnosis, doesn’t directly measure the amount of virus in a specimen. Instead, it copies and amplifies bits of viral genetic material. But that can provide a good approximation of viral load based on the number of amplification cycles it takes for the test to turn positive. The fewer the cycles, the higher the concentration of virus, Bryan explained.

The trigger for higher mortality appeared to be about 22 cycles or fewer, reflecting a viral concentration at least 50,000 times higher than the test’s detection threshold.

Knowing a patient’s viral load could be helpful in managing patients even though treatment options are limited, said Dr. Jennifer Ross, an infectious disease specialist at UW Medicine who also treats COVID-19 patients at the Seattle Veterans Affairs Medical Center.

“It would let the clinician know that if someone is coming in with a very high viral load … that is a bad sign, a poor prognostic sign, as they have shown in this paper,” said Ross, who was not involved in the UW analysis.

Viral load measurements are common for many other respiratory infections and are particularly valuable for patients with compromised immune systems, Ross said.

To understand the relationship between viral loads and death, the UW team analyzed data from UW Medicine’s Northwest campus. For 109 patients admitted to the hospital, the odds of dying within a month of their initial positive test was 4.2 times higher for patients who had high viral loads on admission compared to patients who had low viral loads.

Knowing that threshold might help doctors determine when patients are out of the woods, said Bryan.

“One of the tricky things about COVID-19 is that early on, patients might seem to be doing fine and could be discharged, only to be readmitted later.”

It’s not clear why viral loads vary so widely among people infected with the novel coronavirus. “It’s the difference between a drop or an ocean,” Greninger said. “And we’re not taking that into consideration.”

Weak immune systems probably allow the virus to flourish. And how much virus a person was initially exposed to might be important, but that’s still not clear, he added.

The researchers also found patients whose bodies had already started producing antibodies against the novel coronavirus by the time they were admitted were about half as likely to die as patients without antibodies — though because of the small numbers of those patients, the results were not statistically significant.

Sandi Doughton: 206-464-2491 or sdoughton@seattletimes.com; on Twitter: @SandiDoughton.


Comments:
  1. On November 18, 2020 at 1:17 pm,
    Mike in Albuquerque says:

    If you have been following Covid-19 for a while this isn’t surprising. Higher viral load causes more tissue inflammation which early on was seen as a bad sign. Some of the early treatments were aimed and slowing some aspects of inflammation.

    I highly recommend the following site to those who want to follow the science/medical issues surrounding Covid-19:
    https://medicalxpress.com/coronavirus/

    They take scientific research and make it understandable for all to read.

  2. On November 18, 2020 at 1:40 pm,
    cfs says:

    I am fairly sure,now, that hydroxychloroquine (HCQ) works well, in conjunction with zinc and vitamin D, as prophylaxis. HCQ only works well if given early in the infection.

    On the other hand, Ivermectin, in amounts dependent on body weight, not only works as prophylaxis, BUT WORKS AT ALL TIMES AND LEVELS OF INFECTION.
    A recent double blind trial was performed in Egypt (because the idiots at FDA would not approve it), involving both HCQ and Ivermectin, and I will post a paper of those results when I get to a different computer on which data is stored.

    • On November 18, 2020 at 9:22 pm,
      Big Al says:

      Be interested to read that.

      • On November 19, 2020 at 5:43 am,
        larry says:

        you read that 20 times…no learning at all….no woke moment at all…sad……call in the idiot stooge tool md’s to have us take vaccine vaccine vaccine…lmao

      • On November 19, 2020 at 9:22 am,
        SilverDollar says:

        AL:
        If you’re interested in the Egyptian study, check out Dr. Chris Martenson. He goes over it in https://marketsanity.com/chris-martenson-use-this-one-weird-trick/.
        Viral load has been the one consistent reason most advocates suggest wearing a mask. Sadly, there are those out there that would rather kill health workers than comply with this simple gesture.

  3. On November 18, 2020 at 1:44 pm,
    cfs says:

    By the way, the severity dependence on innoculum (initial viral load) was suspected back in March. This is a reason for using a mask. The correlation was clearly proven in several countries a few months ago.

    • On November 18, 2020 at 9:16 pm,
      Big Al says:

      Thanks Mike,

      I am going to devote the majority of the Weekend Show to Covid with doctors.

  4. On November 18, 2020 at 1:58 pm,
    AJ says:

    https://threader.app/thread/1328393470046838784

    fwiw a good recent twitter thread on current knowledge

  5. On November 18, 2020 at 2:27 pm,
    CFS says:

    https://www.researchsquare.com/article/rs-100956/v1

    Here isthe study, to which I referred above.
    It is quite clear to me that the C.D.C. is far out of date on research, as it appears to assume, only research in the U.S.is worth paying much attention to.

    There are some correlations worth noting:
    High sun intensity nations have less of a problem with covid-19, regardless of their standard of health care or standard of living.
    (This, I believe, is explained by vitamin D being important in decreasing viral replication.)

    A study of all patients worldwide, for which serum Vitamin D levels were published, showed that no one with Blood level of Vitamin D above a certain level equivalent to 4,000 I.U. daily intake died.

    Dietary Zinc and selenium have been shown to reduce infection levels of both corona viruses 1 and 2.

  6. On November 18, 2020 at 2:37 pm,
    larry says:

    good AL…glad you are doing fine…..it is what it is….weird wally world is still all around…..

    • On November 18, 2020 at 9:34 pm,
      Big Al says:

      Getting pretty down for awhile, Larry. Now, I am putting a different perspective on the whole circus. Just stating the facts by experts and no bs.

  7. On November 18, 2020 at 2:41 pm,
    bonzo says:

    Can ivermectin be bought OTC?

    • On November 18, 2020 at 3:55 pm,
      cfs says:

      Ivermectin is given by injection. While available for veterinary use without a prescription, it is not available for human use without a prescription in the U.S.

      It is, however, relatively inexpensive and works much better than Remdesivir, a current recommendation of C.D.C., which is about 50 times more expensive.

    • On November 18, 2020 at 6:10 pm,
      Ebolan says:

      Bonzo…you don’t need it, do you? Hope not…no matter how friendly those little covid fellows are…

      What happened to your relative who got the covids? Weren’t they your in-laws? My recollection was they were OK.

      I don’t know many people diagnosed with the covids but all those except one had no symptoms or slight symptoms except one and it was about as bad as having a bad cold.

      • On November 18, 2020 at 7:52 pm,
        Ebolan says:

        But of course…can anyone really believe the results of the tests? I believe if Carry Mullis were around today he’d call BS on them.

  8. On November 18, 2020 at 3:56 pm,
    Ron says:

    when you refuse treatment or give the wrong treatment people die, higher the viral load the higher the %. People suppressing the treatment for COVID need to get the death penalty

    • On November 18, 2020 at 4:16 pm,
      larry says:

      medical police state wants you vaccinated not healthy……if they wanted you healthy they would demand you prophylactically take ; hydroxyquinone, zinc, selenium, D-3, C……or use quercetin ionophere……but that implies nutrition can cause immuns enhancement and virus eleimination…nonononono…only vaccine can save you!..lmao….youyou weak pathetic humans…remember this,it is impossible to die of nutrient supplements and that will not be said of vaccination…watch it roll out and weep weep weep……no vaccine no money…..vaccine =life in the nazi medical police state……i have been warning this scam for months…it is here now and real…but most will not connect the simple dots…lmao….”got vaccine?”…lolololololol0oll

  9. On November 18, 2020 at 4:26 pm,
    b says:

    Ever rest Larry?

    • On November 18, 2020 at 7:16 pm,
      Dick Tracy says:

      Larry is on a mission, I’m glad that he never received any vaccinations when he was younger or he wouldn’t be here to keep us all well informed. DT

      • On November 19, 2020 at 2:02 am,
        Norrareal1968 says:

        Larry is absolutely correct!

  10. On November 18, 2020 at 6:04 pm,
    larry says:
  11. On November 18, 2020 at 7:47 pm,
    Ebolan says:

    BOYS!

    THE KER COMPANY CAR! (IT’S THE ONE WITH THE CRUSHED DIAMONDS INFUSED IN THE PAINT!)

    https://www.youtube.com/watch?v=pN0LM2AL-gc

  12. On November 18, 2020 at 7:48 pm,
    Dick Tracy says:

    Al, I’m glad your back in the saddle, I was wondering where you had gone and why you disappeared after the election results, as far as being sane I think we should put that to a vote. LOL! DT

  13. On November 18, 2020 at 9:14 pm,
    Buzz says:

    Glad to see Al back in the saddle again. As for me, I take my stage calls from ancient Metalica: Load

    • On November 18, 2020 at 10:24 pm,
      OOTB Jerry says:

      Here is another one………go to the 3:40 mark………
      https://www.youtube.com/watch?v=ze3V_o6ocYo

    • On November 18, 2020 at 10:37 pm,
      OOTB Jerry says:

      btw….:bird brains, is for some other fellows on the three days late follow up….they know who they are…. 🙂

    • On November 19, 2020 at 1:46 am,
      Wayne says:

      You totally misrepresent what I believe just like you have done to others. I do not agree with lockdowns or forced vaccinations for a mostly non-deadly virsus.

      • On November 19, 2020 at 5:13 pm,
        OOTB Jerry says:

        I never misrepresented anything…….I merely posted info. from the very beginning, starting from FEB 22……..The word TOTALLY, is a far stretch., …
        Like I said , before, ….get current with the fact, and Please appear on the DAY, when things are being discussed at the time, and stop coming in THREE DAYS later when everyone has departed, and can not debate at the same time….LIke Several days late the NEWS CHANGES……GET UP TO SPEED……..
        YOU ARE AGAIN, a DAY late……….

        • On November 19, 2020 at 7:01 pm,
          JMiller says:

          And you never post a day or two late? Total BS.

      • On November 19, 2020 at 6:59 pm,
        JMiller says:

        You are lying Jerry. No one on this site ever said they support lockdowns or forced vaccinations. The only debate between people on this site had to do with masks.

  14. On November 19, 2020 at 12:36 am,
    b says:

    Reported on news tonight, 250 thousand covid deaths in the U.S.

    • On November 19, 2020 at 5:19 am,
      larry says:

      b is AL…..the unscientific lame answers are all the same

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