Higher viral loads can possibly increase the risk of death in hospitalised Covid-19 patients.

The risk is even higher in patients who have also been diagnosed with cancer, according to a study published in the journal Cancer Cell.

“Higher viral loads are associated with a greater risk of death among cancer and non-cancer patients hospitalised with coronavirus disease 2019 (Covid-19),” the researchers said.

“Among hospitalised Covid-19 patients, those with hematologic malignancies who had recently been treated for cancer had the highest levels of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes Covid-19,” the study adds.

The methodology

Researchers used two standard diagnostic tests to measure the viral load nose swab specimens from patients admitted in three New York City hospitals between March 15 and May 14, 2020.

Among these patients, 100 patients had active cancer while 2,914 patients did not. Among the cancer patients, some had solid tumours while others had hematologic malignancies.

“Half of patients with hematologic malignancies had high viral loads,” the report said.

“Among patients with hematologic malignancies, only those who had received chemotherapy or targeted therapy during the previous six months had significantly higher viral loads than the general inpatient population with Covid-19,” it added.

Overall, the in-hospital mortality rate in patients with higher viral loads stood at 38.8 per cent. It was 45.2 per cent of patients with cancer.

Further studies required

“We suspect that this finding may be from the underlying immunodeficiencies conferred by either the hematologic malignancies or the administered therapies, which may decrease the ability to inhibit proliferation of SARS-CoV-2,” said co-first author Lars Westblade, an associate professor of pathology and laboratory medicine at Weill Cornell Medicine and a clinical microbiologist at NewYork-Presbyterian/Weill Cornell Medical Center.

However, Westblad added that, “Additional studies with a larger sample size of patients with hematologic malignancies are needed to more definitely assess whether these patients have increased mortality when hospitalised with Covid-19.”

“As a community, we've only begun to understand the relationship between SARS-CoV-2 viral load and outcomes,” said senior study author Michael Satlin, an assistant professor of medicine in the Division of Infectious Diseases at Weill Cornell Medicine and an assistant attending physician at NewYork-Presbyterian/Weill Cornell Medical Center.

“Currently, this quantitative information is not given to patient care teams, and providers only know if a patient’s test is positive or negative. Giving this information to providers of patients with cancer who have Covid-19 could help them decide on which patients should receive more intensive monitoring when they are in the hospital and which should receive new antiviral medicines if these treatments are in short supply,” Satlin added.

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