Influence of viral load in the outcome of hospitalized patients with influenza virus infection

Collection Location Koleksi E-book & E-Journal Perpustakaan Pusat Unila
Call Number
ISBN/ISSN 1435-4373
Author(s) Lalueza, Antonio
Subject(s) Biomedicine
Classification NONE
Series Title
GMD E-Book
Language English
Publisher Springer
Publishing Year 2019
Publishing Place Switzerland
Abstract/Notes Abstract
The role of viral load in the outcome of patients requiring hospital admission due to influenza is not well established.We aim to
assess if there is an association between the viral load and the outcome in hospitalized patients with a confirmed influenza virus
infection. A retrospective observational study including all adult patients who were hospitalized in our center with a confirmed
influenza virus infection from January to May 2016. Viral load was measured by real-time reverse-transcriptase–polymerase
chain reaction (rRT-PCR) cycle threshold (Ct) value on upper respiratory tract samples. Its value was categorized into three
groups (low Ct, ≤ 20; intermediate Ct, > 20–30; and high Ct, > 30). Two hundred thirty-nine patients were included. Influenza A/
H1N1pdm09 was isolated in 207 cases (86.6%). The mean Ct value was 26.69 ± 5.81. The viral load was higher in the
unvaccinated group when compared with the vaccinated patients (Ct 25.17 ± 5.55 vs. 27.58 ± 4.97, p = 0.004). Only 27 patients
(11.29%) presented a high viral load. Patients with a high viral load more often showed abnormal findings on chest X-ray (p =
0.015) and lymphopenia (p = 0.097). By contrast, there were no differences between the three groups (according to viral load), in
associated pneumonia, respiratory failure, need for mechanical ventilation, sepsis, or in-hospital mortality. Our findings suggest
that in patients admitted to the hospital with confirmed influenza virus infection (mostly A/H1N1pdm09), a high viral load is
associated with a higher presence of abnormal findings on chest X-ray but not with a significant worse prognosis. In these cases,
standardized quantitative PCR could be useful.
Keywords Influenza . Pneumonia . Lymphopenia . Viral load . Outcome . Mortality
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