Respiratory Torque Teno Virus load at Emergency department visit
predicts intensive care unit admission of SARS-CoV-2 infected patients
Abstract
Background: Accurate prediction of SARS-CoV-2 severity remains
a challenge. Torque Teno Virus (TTV), recognized as a surrogate marker
for cellular immunity in solid organ transplant recipients, holds
potential for assessing infection outcomes. Objectives: We
investigated whether quantifying TTV in nasopharyngeal samples upon
emergency ward (ED) admission could serve as an early predictor of
SARS-CoV-2 severity. Study design: Retrospective single-center
study in the ED of Saint-Louis Hospital in Paris, France. TTV DNA was
quantified in nasopharyngeal swab samples collected for SARS-CoV-2
testing. Results: Among 295 SARS-CoV-2 infected patients, 92
returned home, 160 were admitted to medical wards, and 43 to the
intensive care unit. Among 295 SARS-CoV-2 patients, 92 were discharged,
160 hospitalized, and 43 admitted to the intensive care unit (ICU).
Elevated TTV loads were observed in ICU patients (Median: 3.02 log
copies/mL, interquartile range [IQR]: 2.215-3.825), exceeding those
in discharged (2.215, [0; 2.962]) or hospitalized patients (2.24,
[0; 3.29]) (p=0.006). Multivariate analysis identified diabetes,
obesity, hepatitis, fever, dyspnea, oxygen requirement, and TTV load as
predictors of ICU admission. A 2.91 log 10 copies/mL TTV
threshold independently predicted ICU admission. Conclusion:
Nasopharyngeal TTV quantification in SARS-CoV-2 infected patients is
linked to the likelihood of ICU admission and might reflect respiratory
immunosuppression.