University of Wisconsin–Madison Medical College of Wisconsin

SARS-CoV-2 Cycle Thresholds, Poverty, Race, and Clinical Outcomes

Frida Rivera, MD, PhD; Cameron G. Gmehlin, BA; Liliana E. Pezzin, PhD, JD; Ryan Hanson, MS; Adriana Perez, MS; Siddhartha Singh, MD, MS, MBA; Nathan A. Ledeboer, PhD; Blake W. Buchan, PhD; Ann B. Nattinger, MD, MPH; L. Silvia Munoz-Price, MD, PhD

WMJ. 2021;120(4):301-304.

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ABSTRACT

Background: Poverty and high viral load are associated with worse outcomes among COVID-19 patients.

Methods: We included patients admitted to Froedtert Health between March 16 and June 1, 2020. SARS-CoV-2 viral load was proxied by cycle-threshold values. To measure poverty, we used Medicaid or uninsured status and residence in socially disadvantaged areas. We assessed the association between viral load and length of stay and discharge disposition, while controlling for demographics and confounders.

Results: Higher viral load was associated with longer length of stay (coefficient -0.02; 95% CI, -0.04 to 0.01; P = 0.006) and higher likelihood of death (coefficient -0.11; 95% CI, -0.17 to -0.06; P < 0.001). Poverty, residence in disadvantaged areas, and race were not.

Discussion: This study confirms a relationship of viral load with in-hospital death, even after controlling for race and poverty.


Author Affiliations: Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Rivera, Munoz-Price); School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Gmehlin, Perez); Collaborative for Healthcare Delivery Science, Medical College of Wisconsin, Milwaukee, Wisconsin (Pezzin, Hanson, Singh, Nattinger); Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin (Pezzin); Froedtert Health, Milwaukee, Wisconsin (Hanson); Division of General Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Ledeboer, Nattinger); Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin (Buchan).
Corresponding Author: L. Silvia Munoz-Price, 8701 W Watertown Plank Rd, Milwaukee, WI 53226; phone 414.955.0483; email smunozprice@mcw.edu.
Funding/Support: This study was partially funded by Advancing a Healthier Wisconsin.
Financial Disclosures: None declared.
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