气候变化领域集成服务门户(CCPortal): Modeling SARS-CoV-2 viral kinetics and association with mortality in hospitalized patients from the French COVID cohort

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DOI	10.1073/pnas.2017962118
	Modeling SARS-CoV-2 viral kinetics and association with mortality in hospitalized patients from the French COVID cohort
	Néant N.; Lingas G.; Le Hingrat Q.; Ghosn J.; Engelmann I.; Lepiller Q.; Gaymard A.; Ferré V.; Hartard C.; Plantier J.-C.; Thibault V.; Marlet J.; Montes B.; Bouiller K.; Lescure F.-X.; Timsit J.-F.; Faure E.; Poissy J.; Chidiac C.; Raffi F.; Kimmoun A.; Etienne M.; Richard J.-C.; Tattevin P.; Garot D.; Le Moing V.; Bachelet D.; Tardivon C.; Duval X.; Yazdanpanah Y.; Mentré F.; Laouénan C.; Visseaux B.; Guedj J.
发表日期	2021
ISSN	00278424
卷号	118 期号:8
英文摘要	The characterization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral kinetics in hospitalized patients and its association with mortality is unknown. We analyzed death and nasopharyngeal viral kinetics in 655 hospitalized patients from the prospective French COVID cohort. The model predicted a median peak viral load that coincided with symptom onset. Patients with age ≥65 y had a smaller loss rate of infected cells, leading to a delayed median time to viral clearance occurring 16 d after symptom onset as compared to 13 d in younger patients (P < 10−4). In multivariate analysis, the risk factors associated with mortality were age ≥65 y, male gender, and presence of chronic pulmonary disease (hazard ratio [HR] > 2.0). Using a joint model, viral dynamics after hospital admission was an independent predictor of mortality (HR = 1.31, P < 10−3). Finally, we used our model to simulate the effects of effective pharmacological interventions on time to viral clearance and mortality. A treatment able to reduce viral production by 90% upon hospital admission would shorten the time to viral clearance by 2.0 and 2.9 d in patients of age <65 y and ≥65 y, respectively. Assuming that the association between viral dynamics and mortality would remain similar to that observed in our population, this could translate into a reduction of mortality from 19 to 14% in patients of age ≥65 y with risk factors. Our results show that viral dynamics is associated with mortality in hospitalized patients. Strategies aiming to reduce viral load could have an effect on mortality rate in this population. © 2021 National Academy of Sciences. All rights reserved.
英文关键词	Mortality; SARS-CoV-2; Viral dynamics
语种	英语
scopus关键词	virus antibody; virus RNA; aged; blood; diagnosis; epidemiology; female; France; genetics; hospitalization; human; isolation and purification; kinetics; male; mortality; nasopharynx; prognosis; prospective study; risk factor; survival rate; theoretical model; virology; virus load; Aged; Antibodies, Viral; COVID-19; Female; France; Hospitalization; Humans; Kinetics; Male; Models, Theoretical; Nasopharynx; Prognosis; Prospective Studies; Risk Factors; RNA, Viral; SARS-CoV-2; Survival Rate; Viral Load
来源期刊	Proceedings of the National Academy of Sciences of the United States of America
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/180553
作者单位	Université de Paris, INSERM, IAME, Paris, F-75018, France; AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, F-75018, France; AP-HP, Hopital Bichat, Service de Maladies Infectieuses et Tropicales, Paris, F-75018, France; Univ. Lille, Virology Laboratory, EA3610, Institute of Microbiology, Centre Hospitalier-Universitaire de Lille, Lille Cedex, F-59037, France; Laboratoire de Virologie, Centre Hospitalier-Universitaire de Besançon, Besançon, F-25000, France; Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, F-69004, France; Centre National de Référence des Virus Respiratoires, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, F-69004, France; Service de Virologie, Centre Hospitalier-Universitaire de Nantes, Nantes, F-44093, France; Laboratoire de Microbiologie, Centre Hospitalier-Universitaire de Nancy, Nancy, F-54000, France; Université de Lorraine, CNRS, Laboratoire de Chimie Physique et Microbiologie pour les Matériaux e...
推荐引用方式 GB/T 7714	Néant N.,Lingas G.,Le Hingrat Q.,et al. Modeling SARS-CoV-2 viral kinetics and association with mortality in hospitalized patients from the French COVID cohort[J],2021,118(8).
APA	Néant N..,Lingas G..,Le Hingrat Q..,Ghosn J..,Engelmann I..,...&Guedj J..(2021).Modeling SARS-CoV-2 viral kinetics and association with mortality in hospitalized patients from the French COVID cohort.Proceedings of the National Academy of Sciences of the United States of America,118(8).
MLA	Néant N.,et al."Modeling SARS-CoV-2 viral kinetics and association with mortality in hospitalized patients from the French COVID cohort".Proceedings of the National Academy of Sciences of the United States of America 118.8(2021).