tetano
Editor, Senior Moderator
Clin Infect Dis
. 2020 Sep 23;ciaa1054.
doi: 10.1093/cid/ciaa1054. Online ahead of print.
High Frequency of SARS-CoV-2 RNAemia and Association With Severe Disease
Catherine A Hogan[SUP] 1 2 [/SUP], Bryan A Stevens[SUP] 1 2 [/SUP], Malaya K Sahoo[SUP] 1 [/SUP], ChunHong Huang[SUP] 1 [/SUP], Natasha Garamani[SUP] 1 [/SUP], Saurabh Gombar[SUP] 1 [/SUP], Fumiko Yamamoto[SUP] 1 [/SUP], Kanagavel Murugesan[SUP] 1 [/SUP], Jason Kurzer[SUP] 1 [/SUP], James Zehnder[SUP] 1 [/SUP], Benjamin A Pinsky[SUP] 1 2 3 [/SUP]
Affiliations
Abstract
Background: Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in blood, also known as RNAemia, has been reported, but its prognostic implications are poorly understood. This study aimed to determine the frequency of SARS-CoV-2 RNA in plasma and its association with coronavirus disease 2019 (COVID-19) clinical severity.
Methods: An analytical cross-sectional study was performed in a single-center tertiary care institution and included consecutive inpatients and outpatients with confirmed COVID-19. The prevalence of SARS CoV-2 RNAemia and the strength of its association with clinical severity variables were examined and included intensive care unit (ICU) admission, invasive mechanical ventilation, and 30-day all-cause mortality.
Results: Paired nasopharyngeal and plasma samples were included from 85 patients. The median age was 55 years, and individuals with RNAemia were older than those with undetectable SARS-CoV-2 RNA in plasma (63 vs 50 years; P = .04). Comorbidities were frequent including obesity (37.6%), hypertension (30.6%), and diabetes mellitus (22.4%). RNAemia was detected in 28/85 (32.9%) of patients, including 22/28 (78.6%) who required hospitalization. In models adjusted for age, RNAemia was detected more frequently in individuals who developed severe disease including ICU admission (32.1 vs 14.0%; P = .04) and invasive mechanical ventilation (21.4% vs 3.5%; P = .02). All 4 deaths occurred in individuals with detectable RNAemia. An additional 121 plasma samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was detected for a maximum duration of 10 days.
Conclusions: This study demonstrated a high proportion of SARS-CoV-2 RNAemia, and an association between RNAemia and clinical severity suggesting the potential utility of plasma viral testing as a prognostic indicator for COVID-19.
Keywords: COVID-19; RNAemia; SARS-CoV-2; blood; severity.
. 2020 Sep 23;ciaa1054.
doi: 10.1093/cid/ciaa1054. Online ahead of print.
High Frequency of SARS-CoV-2 RNAemia and Association With Severe Disease
Catherine A Hogan[SUP] 1 2 [/SUP], Bryan A Stevens[SUP] 1 2 [/SUP], Malaya K Sahoo[SUP] 1 [/SUP], ChunHong Huang[SUP] 1 [/SUP], Natasha Garamani[SUP] 1 [/SUP], Saurabh Gombar[SUP] 1 [/SUP], Fumiko Yamamoto[SUP] 1 [/SUP], Kanagavel Murugesan[SUP] 1 [/SUP], Jason Kurzer[SUP] 1 [/SUP], James Zehnder[SUP] 1 [/SUP], Benjamin A Pinsky[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 32965474
- DOI: 10.1093/cid/ciaa1054
Abstract
Background: Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in blood, also known as RNAemia, has been reported, but its prognostic implications are poorly understood. This study aimed to determine the frequency of SARS-CoV-2 RNA in plasma and its association with coronavirus disease 2019 (COVID-19) clinical severity.
Methods: An analytical cross-sectional study was performed in a single-center tertiary care institution and included consecutive inpatients and outpatients with confirmed COVID-19. The prevalence of SARS CoV-2 RNAemia and the strength of its association with clinical severity variables were examined and included intensive care unit (ICU) admission, invasive mechanical ventilation, and 30-day all-cause mortality.
Results: Paired nasopharyngeal and plasma samples were included from 85 patients. The median age was 55 years, and individuals with RNAemia were older than those with undetectable SARS-CoV-2 RNA in plasma (63 vs 50 years; P = .04). Comorbidities were frequent including obesity (37.6%), hypertension (30.6%), and diabetes mellitus (22.4%). RNAemia was detected in 28/85 (32.9%) of patients, including 22/28 (78.6%) who required hospitalization. In models adjusted for age, RNAemia was detected more frequently in individuals who developed severe disease including ICU admission (32.1 vs 14.0%; P = .04) and invasive mechanical ventilation (21.4% vs 3.5%; P = .02). All 4 deaths occurred in individuals with detectable RNAemia. An additional 121 plasma samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was detected for a maximum duration of 10 days.
Conclusions: This study demonstrated a high proportion of SARS-CoV-2 RNAemia, and an association between RNAemia and clinical severity suggesting the potential utility of plasma viral testing as a prognostic indicator for COVID-19.
Keywords: COVID-19; RNAemia; SARS-CoV-2; blood; severity.