Cancer Patients Hospitalized with a High Viral Load of COVID-19 Have a Greater Risk of Dying

For cancer patients hospitalized with SARS-CoV-2 (COVID-19), higher viral load is linked to a greater risk of death, according to a study published in the journal Cell.

Researchers two diagnostic tests to measure the amount of SARS-CoV-2 in load in nasal swabs, which they obtained upon admission to three New York City hospitals between March 15 and May 14, 2020. They assessed 1000 patients with active cancer, and 2,914 patients without cancer. Overall, about half of patients with cancer had viral loads juxtaposed to 30% of non-cancer patients. Also, among cancer patients, only those who had received chemotherapy or targeted therapy during the previous six months had significantly higher viral loads.

Half of patients with hematologic malignancies had high viral loads, compared to approximately 30% of patients without cancer. 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.

According to the results, the in-hospital mortality rate for non-cancer patients was 38.8% among patients with a high viral load, 24.1% among patients with a medium viral load, and 15.3% among patients with a low viral load. Cancer patients showed a similar pattern, with mortality rates of 45.2%, 28.0%, and 12.1%, respectively. High viral loads in patients with cancer were correlated with increased in-hospital mortality than low viral loads. The researchers noted that this finding remained statistically significant, even after adjusting for age, and need for supplemental oxygen within the first few hours of presentation to the emergency department.

 

“As a community, we’ve only begun to understand the relationship between SARS-CoV-2 viral load and outcomes,” says 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 New York-Presbyterian/Weill Cornell Medical Center via a press release. “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.”