tetano
Editor, Senior Moderator
PLoS One
. 2020 Nov 24;15(11):e0242917.
doi: 10.1371/journal.pone.0242917. eCollection 2020.
Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study
Tobias Schlesinger[SUP] 1 [/SUP], Benedikt Wei?brich[SUP] 2 [/SUP], Florian Wedekink[SUP] 3 [/SUP], Quirin Notz[SUP] 1 [/SUP], Johannes Herrmann[SUP] 1 [/SUP], Manuel Krone[SUP] 4 [/SUP], Magdalena Sitter[SUP] 1 [/SUP], Benedikt Schmid[SUP] 1 [/SUP], Markus Kredel[SUP] 1 [/SUP], Jan Stumpner[SUP] 1 [/SUP], Lars D?lken[SUP] 2 5 [/SUP], J?rg Wischhusen[SUP] 3 [/SUP], Peter Kranke[SUP] 1 [/SUP], Patrick Meybohm[SUP] 1 [/SUP], Christopher Lotz[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS).
Methods: This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay.
Results: Most patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009).
Conclusions: COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.
. 2020 Nov 24;15(11):e0242917.
doi: 10.1371/journal.pone.0242917. eCollection 2020.
Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study
Tobias Schlesinger[SUP] 1 [/SUP], Benedikt Wei?brich[SUP] 2 [/SUP], Florian Wedekink[SUP] 3 [/SUP], Quirin Notz[SUP] 1 [/SUP], Johannes Herrmann[SUP] 1 [/SUP], Manuel Krone[SUP] 4 [/SUP], Magdalena Sitter[SUP] 1 [/SUP], Benedikt Schmid[SUP] 1 [/SUP], Markus Kredel[SUP] 1 [/SUP], Jan Stumpner[SUP] 1 [/SUP], Lars D?lken[SUP] 2 5 [/SUP], J?rg Wischhusen[SUP] 3 [/SUP], Peter Kranke[SUP] 1 [/SUP], Patrick Meybohm[SUP] 1 [/SUP], Christopher Lotz[SUP] 1 [/SUP]
Affiliations
- PMID: 33232382
- DOI: 10.1371/journal.pone.0242917
Abstract
Background: The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS).
Methods: This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay.
Results: Most patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009).
Conclusions: COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.