Session Type: 1,5-hour Oral Session
Session Title: 1,5-hour Oral Session
Authors(s): K. Hagman (1), M. Hedenstierna (2), J. Rudling (2), P. Gille-Johnson (2), B. Hammas (3), M. Grabbe (3), J. Jakobsson (4), J. Dillner (5), J. Ursing (2)
Authors Affiliations(s): (1) Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Sweden, (2) Department of Infectious Diseases, Danderyd Hospital, Sweden, (3) Department of Microbiology, Karolinska University Hospital, Sweden, (4) Department of Anesthesia and Intensive Care, Danderyd Hospital, Sweden, (5) Karolinska University Laboratory, Sweden
Background:
SARS-CoV-2 viremia at hospital admission is associated with high risk for ICU-care and mortality. Data on duration of viremia are limited.
Methods:Time to serum viral clearance was studied in a cohort of viremic adults hospitalized for COVID-19. Serum viral clearance was defined as the day after the last positive serum sample.
Results:A total of 121 patients were included. Median age was 62 (IQR 52-71) years and 68% were males. Kaplan-Meier estimate of median time from symptom onset to serum viral clearance was 15 (IQR 14-16) days. Median time to serum viral clearance was delayed in non-survivors (20 [IQR 15-25] days, n = 40), compared to survivors (14 [IQR 13-15] days, n = 81). The median time to serum viral clearance was shorter for corticosteroid treated (12 [IQR 11-17] days, n =22) compared to untreated patients (15 [IQR 14-17] days, n = 99). In-hospital mortality (subdistribution hazard ratio [SHR] 0.21 [95% CI 0.11-0.41]) and immunosuppression (SHR 0.34 [95% CI 0.18-0.62]) were associated with a reduced incidence of serum viral clearance in a multivariate competing risk regression analysis. Receiving corticosteroids was associated with an increased (SHR 1.79 [95% CI 1.08-2.97]) incidence of serum viral clearance. CT values increased over time until SARS-CoV-2 RNA was no longer detected which coincided with defervescence and decreasing C-reactive protein.
Conclusions:Time from symptom onset to serum viral clearance was longer in non-survivors compared to survivors. Time to serum viral clearance was shorter in patients treated with corticosteroids, however numbers are limited.
Keyword(s): viremia, RNAemia, SARS-CoV-2Session Type: 1,5-hour Oral Session
Session Title: 1,5-hour Oral Session
Authors(s): K. Hagman (1), M. Hedenstierna (2), J. Rudling (2), P. Gille-Johnson (2), B. Hammas (3), M. Grabbe (3), J. Jakobsson (4), J. Dillner (5), J. Ursing (2)
Authors Affiliations(s): (1) Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Sweden, (2) Department of Infectious Diseases, Danderyd Hospital, Sweden, (3) Department of Microbiology, Karolinska University Hospital, Sweden, (4) Department of Anesthesia and Intensive Care, Danderyd Hospital, Sweden, (5) Karolinska University Laboratory, Sweden
Background:
SARS-CoV-2 viremia at hospital admission is associated with high risk for ICU-care and mortality. Data on duration of viremia are limited.
Methods:Time to serum viral clearance was studied in a cohort of viremic adults hospitalized for COVID-19. Serum viral clearance was defined as the day after the last positive serum sample.
Results:A total of 121 patients were included. Median age was 62 (IQR 52-71) years and 68% were males. Kaplan-Meier estimate of median time from symptom onset to serum viral clearance was 15 (IQR 14-16) days. Median time to serum viral clearance was delayed in non-survivors (20 [IQR 15-25] days, n = 40), compared to survivors (14 [IQR 13-15] days, n = 81). The median time to serum viral clearance was shorter for corticosteroid treated (12 [IQR 11-17] days, n =22) compared to untreated patients (15 [IQR 14-17] days, n = 99). In-hospital mortality (subdistribution hazard ratio [SHR] 0.21 [95% CI 0.11-0.41]) and immunosuppression (SHR 0.34 [95% CI 0.18-0.62]) were associated with a reduced incidence of serum viral clearance in a multivariate competing risk regression analysis. Receiving corticosteroids was associated with an increased (SHR 1.79 [95% CI 1.08-2.97]) incidence of serum viral clearance. CT values increased over time until SARS-CoV-2 RNA was no longer detected which coincided with defervescence and decreasing C-reactive protein.
Conclusions:Time from symptom onset to serum viral clearance was longer in non-survivors compared to survivors. Time to serum viral clearance was shorter in patients treated with corticosteroids, however numbers are limited.
Keyword(s): viremia, RNAemia, SARS-CoV-2