SARS-CoV-2 Viral Load Predicts Mortality in Patients with and Without Cancer Who Are Hospitalized with COVID-19

Westblade, Lars F.; Brar, Gagandeep; Pinheiro, Laura C.; Paidoussis, Demetrios; Rajan, Mangala; Martin, Peter; Goyal, Parag; Sepulveda, Jorge L.; Zhang, Lisa; George, Gary; Liu, Dakai; Whittier, Susan; Plate, Markus; Small, Catherine B.; Rand, Jacob H.; Cushing, Melissa M.; Walsh, Thomas J.; Cooke, Joseph; Safford, Monika M.; Loda, Massimo; Satlin, Michael J.

Patients with cancer may be at increased risk of severe coronavirus disease 2019 (COVID-19), but the role of viral load on this risk is unknown. We measured SARS-CoV-2 viral load using cycle threshold (C T ) values from reverse transcription-polymerase chain reaction assays applied to nasopharyngeal swab specimens in 100 patients with cancer and 2914 without cancer who were admitted to three New York City hospitals. Overall, the in-hospital mortality rate 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 (P<0.001). Similar findings were observed in patients with cancer (high, 45.2% mortality; medium, 28.0%; low, 12.1%; P=0.008). Patients with hematologic malignancies had higher median viral loads (C T =25.0) than patients without cancer (C T =29.2; P=0.0039). SARS-CoV-2 viral load results may offer vital prognostic information for patients with and without cancer who are hospitalized with COVID-19.