Critically ill patients with COVID-19 in Hong Kong: a multicentre retrospective observational cohort study

2 , 4 It is not clear if the use of antivirals contributed to our lower ICU admission and mortality rates; however, a recent, underpowered placebo-controlled randomised controlled trial showed a trend toward improved outcome with lopinavir–ritonavir. 10 There are data showing that upper respiratory viral loads reach nadir at about Day 9 of illness, which coincides with time to ICU admission in our study, suggesting that severe disease is not due to overwhelming infection and antivirals may not change the outcome of critically ill patients. 11 , 12 However our data show that while nasopharynx SARS-CoV-2 viral load did not correlate with clinical deterioration, tracheal aspirate viral loads were persistently higher than nasopharyngeal viral loads.

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