Dynamics of Torque Teno Virus DNA Load in Bronchoalveolar Lavage in COVID-19 associated Acute Respiratory Distress Syndrome

Dynamics of Torque Teno Virus DNA Load in Bronchoalveolar Lavage in COVID-19 associated Acute Respiratory Distress Syndrome | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 6 January 2026 V1 Latest version Share on Dynamics of Torque Teno Virus DNA Load in Bronchoalveolar Lavage in COVID-19 associated Acute Respiratory Distress Syndrome Authors : Armin M Bumberger 0009-0009-7980-7010 , Marie-Theres Kastner , Lina Rüsing , Iwan Wukits 0009-0005-3009-8605 , Monika Breuer , Robert Strassl , and Oliver Robak [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.176770094.44860022/v1 274 views 104 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background: Torque teno virus (TTV) DNA load has been proposed as a surrogate marker of the net state of immunosuppression. While plasma TTV levels have been associated with infection risk and adverse outcomes, the clinical relevance of TTV in the lower respiratory tract of patients with acute respiratory distress syndrome (ARDS) remains unclear. We investigated bronchoalveolar lavage (BAL) TTV dynamics in COVID-19–associated ARDS, including patients treated with extracorporeal membrane oxygenation (ECMO). Methods: This retrospective single-center cohort study analyzed 179 biobanked BAL samples from 50 adults with PCR-confirmed COVID-19 ARDS. TTV DNA was quantified by qPCR. BAL TTV concentrations were compared between ECMO and non-ECMO patients, before and after ECMO explantation, and between ICU survivors and non-survivors. Associations between early BAL TTV levels and outcome were assessed. Results: BAL TTV concentrations increased significantly over time following ICU admission (R 2 = 0.1816; p < 0.0001) but did not differ significantly between ECMO and non-ECMO patients. In paired analyses, a non-significant trend toward higher BAL TTV levels after ECMO explantation was observed (p=0.078). Early BAL TTV concentrations were not associated with ICU mortality or higher rates of pulmonary, bloodstream, fungal infections, or herpesvirus reactivations. Conclusions: In COVID-19–associated ARDS, BAL TTV showed interesting dynamics with regards to time and the use of ECMO but did not predict mortality or secondary infections. These findings support the need for prospective studies integrating plasma and respiratory TTV kinetics with immune profiling but indicate limited clinical utility of BAL TTV as a standalone biomarker. Supplementary Material File (bal ttv in covid-19 ards.docx) Download 11.55 MB Information & Authors Information Version history V1 Version 1 06 January 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords dna extraction immune system infection pathogenesis research and analysis methods Authors Affiliations Armin M Bumberger 0009-0009-7980-7010 Department of Medicine I, Medical University of Vienna View all articles by this author Marie-Theres Kastner Department of Medicine I, Medical University of Vienna View all articles by this author Lina Rüsing Department of Medicine I, Medical University of Vienna View all articles by this author Iwan Wukits 0009-0005-3009-8605 Department of Medicine I, Medical University of Vienna View all articles by this author Monika Breuer Department of Laboratory Medicine, Medical University of Vienna View all articles by this author Robert Strassl Department of Laboratory Medicine, Medical University of Vienna View all articles by this author Oliver Robak [email protected] Department of Medicine I, Medical University of Vienna View all articles by this author Metrics & Citations Metrics Article Usage 274 views 104 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Armin M Bumberger, Marie-Theres Kastner, Lina Rüsing, et al. Dynamics of Torque Teno Virus DNA Load in Bronchoalveolar Lavage in COVID-19 associated Acute Respiratory Distress Syndrome. Authorea . 06 January 2026. DOI: https://doi.org/10.22541/au.176770094.44860022/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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