Objectives. This study is aimed at exploring the relationship of the viral load of coronavirus disease 2019 (COVID-19) with lymphocyte count, neutrophil count, and C-reactive protein (CRP) and investigating the dynamic change of patients’ viral load during the conversion from mild COVID-19 to severe COVID-19, so as to clarify the correlation between the viral load and progression of COVID-19. Methods. This paper included 38 COVID-19 patients admitted to the First Hospital of Jiaxing from January 28, 2020, to March 6, 2020, and they were clinically classified according to the Guidelines on the Novel Coronavirus-Infected Pneumonia Diagnosis and Treatment. According to the instructions of the Nucleic Acid Detection Kit for the 2019 novel coronavirus (SARS-CoV-2), respiratory tract specimens (throat swabs) were collected from patients for nucleic acid testing. Patients’ lymphocyte count and neutrophil count were determined by blood routine examination, and CRP was measured by biochemical test. Results. The results of our study suggested that the cycle threshold (Ct) value of Nucleocapsid protein (N) gene examined by nucleic acid test was markedly positively correlated with lymphocyte count (, ), but negatively correlated with neutrophil count (, ) and CRP (, ), which indicated that patients with a higher viral load tended to have lower lymphocyte count but higher neutrophil count and CRP. Additionally, we detected the dynamic change of Ct value in patients who developed into a severe case, finding that viral load of 3 patients increased before disease progression, whereas this phenomenon was not found in 2 patients with underlying diseases. Conclusion. The results of this study demonstrated that viral load of SARS-CoV-2 is significantly negatively correlated with lymphocyte count, but markedly positively correlated with neutrophil count and CRP. The rise of viral load is very likely to be the key factor leading to the overloading of the body’s immune response and resulting in the disease progression into severe disease.

中文翻译：

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病毒载量与COVID-19进展的相关性分析

目标。本研究旨在探索 2019 冠状病毒病（COVID-19）病毒载量与淋巴细胞计数、中性粒细胞计数和 C 反应蛋白（CRP）的关系，并研究患者病毒载量在从病毒转为病毒的过程中的动态变化。轻度 COVID-19 到重度 COVID-19，以阐明病毒载量与 COVID-19 进展之间的相关性。方法. 本文纳入2020年1月28日至2020年3月6日嘉兴市第一医院收治的38例COVID-19患者，根据《新型冠状病毒感染的肺炎诊疗指南》进行临床分类。根据2019新型冠状病毒（SARS-CoV-2）核酸检测试剂盒说明书，采集患者呼吸道标本（咽拭子）进行核酸检测。患者的淋巴细胞计数和中性粒细胞计数通过血常规检查确定，CRP通过生化试验测定。结果。我们的研究结果表明，核酸检测核衣壳蛋白（N）基因的循环阈值（Ct）值与淋巴细胞计数呈显着正相关（, ),但与中性粒细胞计数呈负相关 (, )和协调反应蛋白 (, )，这表明病毒载量较高的患者往往淋巴细胞计数较低，但嗜中性粒细胞计数和 CRP 较高。此外，我们检测了发展为重症患者的Ct值的动态变化，发现3名患者在疾病进展前病毒载量增加，而2名有基础疾病的患者没有发现这种现象。结论。这项研究的结果表明，SARS-CoV-2 的病毒载量与淋巴细胞计数呈显着负相关，但与中性粒细胞计数和 CRP 呈显着正相关。病毒载量的上升很可能是导致机体免疫反应超负荷、导致疾病进展为重症的关键因素。