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J Med Virol
. 2021 Feb 16.
doi: 10.1002/jmv.26876. Online ahead of print.
Quantitative assessment of SARS-CoV-2 RNAemia and outcome in patients with Coronavirus Disease 2019
Kefu Tang 1 , Lei Wu 1 , Ying Luo 1 , Bo Gong 1
Affiliations
- PMID: 33590923
- DOI: 10.1002/jmv.26876
Abstract
The disease spectrum of COVID-19 varies from asymptomatic infection to critical illness and death. Identification of prognostic marker is vital for predicting progression and clinical practice. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, known as RNAemia has been detected in blood. However, the potential clinical value of SARS-CoV-2 RNAemia remains unknown. We therefore conducted a meta-analysis using a random-effects model to estimate pooled prevalence of SARS-CoV-2 RNAemia as well as summary strength of RNAemia in association with disease severity and unfavorable clinical outcomes. A total of 21 studies involving 2181 patients were included. SARS-CoV-2 RNAemia in COVID-19 patients varied from 9.4% to 74.1%, with a pooled estimate of 34% (95% CI: 26-43%). Overall, SARS-CoV-2 RNAemia was associated with COVID-19 severity with OR of 5.43 (95% CI: 3.46-8.53). In addition, SARS-CoV-2 RNAemia was a significant risk factor for unfavorable clinical outcomes (OR = 6.54, 95% CI: 3.82-11.21). The summary OR was 4.28 (95% CI: 2.20-8.33) for ICU admission, 11.07 (95% CI: 5.60-21.88) for mortality. Furthermore, RNAemia was also a significant risk factor for invasive mechanical ventilation and multiple organ failure. SARS-CoV-2 RNAemia is associated with disease severity, ICU admission, death in COVID-19 and may serve as clinical predictor. More prospective trials in evaluating the potential of SARS-CoV-2 RNAemia as prognostic indicator are necessary. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; SARS-CoV-2 RNAaemia; clinical severity; unfavorable outcome.