Elevated SARS-CoV-2 in peripheral blood and increased COVID-19 severity in American Indians/Alaska Natives Journalartikel uri icon



  • Epidemiological data across the United States show health disparities in COVID-19 infection, hospitalization, and mortality by race/ethnicity. While the association between elevated SARS-CoV-2 viral loads (VLs) (i.e. upper respiratory tract (URT) and peripheral blood (PB)) and increased COVID-19 severity has been reported, data remain largely unavailable for some disproportionately impacted racial/ethnic groups, particularly for American Indian or Alaska Native (AI/AN) populations. As such, we determined the relationship between SARS-CoV-2 VL dynamics and disease severity in a diverse cohort of hospitalized patients. Results presented here are for study participants ( n = 94, ages 21–88 years) enrolled in a prospective observational study between May and October 2020 who had SARS-CoV-2 viral clades 20A, C, and G. Based on self-reported race/ethnicity and sample size distribution, the cohort was stratified into two groups: (AI/AN, n = 43) and all other races/ethnicities combined (non-AI/AN, n = 51). SARS-CoV-2 VLs were quantified in the URT and PB on days 0–3, 6, 9, and 14. The strongest predictor of severe COVID-19 in the study population was the mean VL in PB (OR = 3.34; P = 2.00 × 10−4). The AI/AN group had the following: (1) comparable co-morbidities and admission laboratory values, yet more severe COVID-19 (OR = 4.81; P = 0.014); (2) a 2.1 longer duration of hospital stay ( P = 0.023); and (3) higher initial and cumulative PB VLs during severe disease ( P = 0.025). Moreover, self-reported race/ethnicity as AI/AN was the strongest predictor of elevated PB VLs ( β = 1.08; P = 6.00 × 10−4) and detection of SARS-CoV-2 in PB (hazard ratio = 3.58; P = 0.004). The findings presented here suggest a strong relationship between PB VL (magnitude and frequency) and severe COVID-19, particularly for the AI/AN group.


  • Perkins, Douglas J
  • Yingling, Alexandra V
  • Cheng, Qiuying
  • Castillo, Amber
  • Martinez, Janae
  • Bradfute, Steven B
  • Leng, Shuguang
  • Edwards, Jeremy
  • Guo, Yan
  • Mertz, Gregory
  • Harkins, Michelle
  • Unruh, Mark
  • Worsham, Anthony
  • Lambert, Christophe G
  • Teixeira, J Pedro
  • Seidenberg, Phillip
  • Langsjoen, Jens
  • Schneider, Kristan
  • Hurwitz, Ivy


  • 2022


  • Open Access


  • 14


  • 247


  • 1253

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