{"id":24192,"date":"2026-03-17T11:07:00","date_gmt":"2026-03-17T09:07:00","guid":{"rendered":"https:\/\/ibsal.es\/study-shows-that-60-of-critically-ill-covid-19-patients-have-live-virus-in-their-lungs-at-the-time-of-intubation\/"},"modified":"2026-08-04T12:51:15","modified_gmt":"2026-08-04T10:51:15","slug":"study-shows-that-60-of-critically-ill-covid-19-patients-have-live-virus-in-their-lungs-at-the-time-of-intubation","status":"publish","type":"post","link":"https:\/\/ibsal.es\/en\/study-shows-that-60-of-critically-ill-covid-19-patients-have-live-virus-in-their-lungs-at-the-time-of-intubation\/","title":{"rendered":"Study Shows That 60% of Critically Ill COVID-19 Patients Have Live Virus in Their Lungs at the Time of Intubation"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>The study\u2014published in <em>*Anesthesiology, Anaesthesia, Critical Care &amp; Pain Medicine*<\/em>\u2014identifies two types of critically ill patients, which has significant implications for the design of clinical trials involving antiviral drugs.<\/strong><\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\"><strong>This study is a subproject of the CIBERUCICOVID project under CIBERES and is co-funded by UNESPA and the ISCIII COVID-19 Fund.<\/strong><\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\"><strong>The strategy developed could be applied to other severe respiratory viral infections, such as seasonal or pandemic influenza<\/strong>.<\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\">A new study answers one of the major unanswered questions left by the pandemic: whether, when a person with COVID-19 reached a critical condition and required invasive mechanical ventilation, the virus was still actively replicating in the lungs, or whether the respiratory damage was solely a consequence of the inflammatory response. The answer is clear: <strong>60% of critically ill patients have live virus in their lungs at the time of intubation.<\/strong> <\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\">This study is a subproject of <strong>the CIBERUCICOVID project<\/strong> of the Biomedical Research Network Center for Respiratory Diseases (CIBERES), which investigates personalized prognostic risk factors and one-year follow-up of patients admitted to Spanish intensive care units who are infected with the SARS-CoV-2 virus. The study is coordinated by a CIBERES research team based at the Salamanca Institute for Biomedical Research (IBSAL) and co-funded through UNESPA\u2019s \u201cEstar Preparados\u201d Program and the ISCIII\u2019s COVID-19 Fund. <\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\">The research, published in <em>*Anaesthesia Critical Care &amp; Pain Medicine*<\/em>, was based on a study conducted in collaboration with the Jerez University Hospital. The study included 159 critically ill patients admitted to its ICU and was conducted, among others, in collaboration with the Institute of Medical Microbiology at Jena University Hospital (Germany), where viral cultures were performed to confirm the presence of replicating virus. <\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<h4 class=\"wp-block-heading\"><strong>Two Distinct Profiles of Critically Ill Patients<\/strong><\/h4>\n\n<p class=\"wp-block-paragraph\">In addition to demonstrating the persistence of live virus in most critically ill patients, the research team identified two clearly distinct patterns regarding the timing of the initiation of invasive mechanical ventilation.<\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\">On the one hand, there are patients who progress rapidly from the onset of symptoms to respiratory failure and the need for mechanical ventilation. This group exhibits high levels of live virus in the lungs and clear evidence of active replication. <\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\">On the other hand, patients whose disease progresses more slowly and who are placed on mechanical ventilation at a later stage, when the pulmonary viral load is low or the virus is no longer detectable by culture.<\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\"><em>\u201cThis distinction has profound implications for the design of future clinical trials with antivirals. The results suggest that not all critically ill patients would benefit equally from these treatments and that stratification based on the presence of viable virus could be key to optimizing their administration,\u201d<\/em> explain Jes\u00fas F. Bermejo-Martin \u2014study coordinator and researcher at CIBERES at the Institute of Biomedical Research of Salamanca (IBSAL) and the University of Salamanca\u2014 and \u00c1ngel Estella, \u2014first author at the University Hospital of Jerez.<\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\">Recognizing that viral culture is not available in most hospitals, the research team developed and refined an alternative method based on digital PCR to identify patients with replicating virus in the lungs. This technology, already implemented in numerous centers, makes it possible to detect viable virus without the need for specialized cell culture infrastructure. <\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\">This breakthrough makes it easier to identify critically ill patients who might benefit from antiviral treatment and paves the way for more personalized medicine in the ICU setting.<\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<h4 class=\"wp-block-heading\"><strong>Implications Beyond COVID-19<\/strong><\/h4>\n\n<p class=\"wp-block-paragraph\">Ferr\u00e1n Barb\u00e9, the project coordinator and a researcher at CIBERES at the Institute for Biomedical Research of Lleida (IRBLleida), emphasizes that the strategy developed is not limited to SARS-CoV-2: <em>\u201cIt could be applied to other severe respiratory viral infections, such as seasonal or pandemic influenza, as well as to future emerging threats.\u201d<\/em><\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\">Overall, this study represents a significant advance in our understanding of the pathophysiology of severe respiratory failure caused by respiratory viral infections and lays the groundwork for improving future clinical trials of antiviral drugs in critically ill patients.<\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<figure class=\"wp-block-image size-large\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"446\" src=\"https:\/\/ibsal.es\/wp-content\/uploads\/2026\/03\/CIBERESUCICOVID-1024x446.jpg\" alt=\"\" class=\"wp-image-21507\" srcset=\"https:\/\/ibsal.es\/wp-content\/uploads\/2026\/03\/CIBERESUCICOVID-1024x446.jpg 1024w, https:\/\/ibsal.es\/wp-content\/uploads\/2026\/03\/CIBERESUCICOVID-300x131.jpg 300w, https:\/\/ibsal.es\/wp-content\/uploads\/2026\/03\/CIBERESUCICOVID-768x335.jpg 768w, https:\/\/ibsal.es\/wp-content\/uploads\/2026\/03\/CIBERESUCICOVID-1536x670.jpg 1536w, https:\/\/ibsal.es\/wp-content\/uploads\/2026\/03\/CIBERESUCICOVID.jpg 1782w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n<p class=\"wp-block-paragraph\">From left to right: Jes\u00fas Bermejo, Ferr\u00e1n Barb\u00e9, \u00c1ngel Estella, and Stephanie Deinhardt-Emmer.<\/p>\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<p class=\"wp-block-paragraph\"><strong>Article reference:<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Estella A, Tedim AP, H\u00e4der A, Ortega A, Garc\u00eda-Mateo N, de la Fuente A, et al. <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2352556826000378\"><strong>Poor control of pulmonary viral replication in COVID-19 patients with early respiratory failure<\/strong><\/a>. <em>Anaesth Crit Care Pain Med<\/em>. February 25, 2026:101779. doi: 10.1016\/j.accpm.2026.101779. Published online ahead of print. PMID: 41759657.<\/p>\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The study\u2014published in *Anesthesiology, Anaesthesia, Critical Care &amp; Pain Medicine*\u2014identifies two types of critically ill patients, which has significant implications for the design of clinical trials involving antiviral drugs. This [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":24193,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"categories":[238,239],"tags":[241],"class_list":["post-24192","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-news-highlights","tag-microbiology"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v20.12 (Yoast SEO v28.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Study Shows That 60% of Critically Ill COVID-19 Patients Have Live Virus in Their Lungs at the Time of Intubation | IBSAL<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ibsal.es\/en\/study-shows-that-60-of-critically-ill-covid-19-patients-have-live-virus-in-their-lungs-at-the-time-of-intubation\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Study Shows That 60% of Critically Ill COVID-19 Patients Have Live Virus in Their Lungs at the Time of Intubation\" \/>\n<meta property=\"og:description\" content=\"The study\u2014published in *Anesthesiology, Anaesthesia, Critical Care &amp; Pain Medicine*\u2014identifies two types of critically ill patients, which has significant implications for the design of clinical trials involving antiviral drugs. 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