%0 Journal Article 
%A Bermejo Martin, Jesús F.
%A García Mateo, Nadia
%A Motos, Anna
%A Resino, Salvador
%A Tamayo, Luis
%A Ryan Murua, Pablo
%A Bustamante Munguira, Elena
%A Gallego Curto, Elena
%A Úbeda Iglesias, Alejandro
%A de la Torre, María del Carmen
%A Estella García, Ángel
%A Campos Fernández, Sandra
%A Martínez Varela, Ignacio
%A Pérez García, Felipe
%A Socias, Lorenzo
%A López Messa, Juan
%A Vidal Cortés, Pablo
%A Sagredo Meneses, Víctor
%A González Rivera, Milagros
%A Carbonell, Nieves
%A de Gonzalo Calvo, David
%A Martín Delgado, María Cruz
%A Valdivia, Luis Jorge
%A Martín López, Caridad
%A Jorge García, Ruth Noemí
%A Maseda, Emilio
%A Loza Vázquez, Ana
%A Kelvin, David J.
%A Barbé, Ferrán
%A Torres, Antoni
%A Ortega, Alicia
%A de la Fuente, Amanda
%A Almansa, Raquel
%A Postigo, Tamara
%A Jorge, Noelia
%A Tedim, Ana P.
%A González González, Laura
%A Sánchez Recio, Lara
%A Trapiello, Wysali
%A Berezo, José Ángel
%A Herrán Monge, Rubén
%A Blanco, Jesús
%A Enríquez, Pedro
%A Martínez, Isidoro
%A Martín Vicente, María
%A Muñoz Gómez, María José
%A Más, Vicente
%A Vázquez, Mónica
%A Cano, Olga
%A Martínez de la Gándara, Amalia
%A Rodríguez, Covadonga
%A Andrade, Gloria
%A Renedo, Gloria
%A Bustamante Munguira, Juan
%A Cicuendez Ávila, Ramón
%A Salgado Villén, María
%A Berruguilla Pérez, Enrique
%A Güell, Estel
%A Casadiego Monachello, Fernando Javier
%A Recuerda Núñez, María
%A Sánchez Calvo, Juan Manuel
%A Peñasco Martín, Yhivian
%A García Unzueta, María Teresa
%A Ceccato, Adrián
%A Fernández Barat, Laia
%A Bouza Vieiro, María Teresa
%A Moreno Romero, Ana
%A Pérez Bastida, Leire
%A del Río Carbajo, Lorena
%A Albalá Martínez, Noelia
%A Gómez, José Manuel
%A Blasco, María Luisa
%A Caballero, Jesús
%A Barberà, Carme
%A González, Jessica
%A Nieto, María Teresa
%A Nieto del Olmo, Jorge
%A Prol Silva, Estefanía
%A Canseco Ribas, Joan
%A Eiros, Jose María
%T Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study
%D 2023
%@ 2666-5247
%U http://hdl.handle.net/10498/29593
%X Background: The contribution of the virus to the pathogenesis of severe COVID-19 is still unclear. We aimed to evaluate associations between viral RNA load in plasma and host response, complications, and deaths in critically ill patients with COVID-19. Methods: We did a prospective cohort study across 23 hospitals in Spain. We included patients aged 18 years or older with laboratory-confirmed SARS-CoV-2 infection who were admitted to an intensive care unit between March 16, 2020, and Feb 27, 2021. RNA of the SARS-CoV-2 nucleocapsid region 1 (N1) was quantified in plasma samples collected from patients in the first 48 h following admission, using digital PCR. Patients were grouped on the basis of N1 quantity: VIR-N1-Zero ([removed]2747 N1 copies per mL). The primary outcome was all-cause death within 90 days after admission. We evaluated odds ratios (ORs) for the primary outcome between groups using a logistic regression analysis. Findings: 1068 patients met the inclusion criteria, of whom 117 had insufficient plasma samples and 115 had key information missing. 836 patients were included in the analysis, of whom 403 (48%) were in the VIR-N1-Low group, 283 (34%) were in the VIR-N1-Storm group, and 150 (18%) were in the VIR-N1-Zero group. Overall, patients in the VIR-N1-Storm group had the most severe disease: 266 (94%) of 283 patients received invasive mechanical ventilation (IMV), 116 (41%) developed acute kidney injury, 180 (65%) had secondary infections, and 148 (52%) died within 90 days. Patients in the VIR-N1-Zero group had the least severe disease: 81 (54%) of 150 received IMV, 34 (23%) developed acute kidney injury, 47 (32%) had secondary infections, and 26 (17%) died within 90 days (OR for death 0·30, 95% CI 0·16–0·55; p<0·0001, compared with the VIR-N1-Storm group). 106 (26%) of 403 patients in the VIR-N1-Low group died within 90 days (OR for death 0·39, 95% CI 0·26–0·57; p[removed]
%K COVID-19
%K viral R  load
%K cause death
%~ Universidad de Cádiz