SARS-CoV-2 viremia but not respiratory viral load is associated with ventilator complications

COVID-19 can cause acute respiratory distress syndrome (ARDS) associated with high morbidity and mortality. Previous studies have shown an association between plasma viral load (VL) of severe acute respiratory distress (SARS-Cov2) and disease severity. This study is one of the first to measure endotracheal aspirate (ETA) VL in addition to plasma VL in patients admitted to the medical intensive care unit with COVID-19. Viral load from both plasma and ETA decreased over time. Subjects with high plasma VL experienced a greater number of adverse events, including ventilator-associated pneumonia (VAP), increased number of days on mechanical ventilation, and increased number of days in hospital. There was no association between ETA VL and adverse events.