tetano
Editor, Senior Moderator
Viruses
. 2020 Sep 18;12(9):E1045.
doi: 10.3390/v12091045.
RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients
Kirsten Alexandra Eberhardt[SUP] 1 [/SUP], Charlotte Meyer-Schwickerath[SUP] 2 [/SUP], Eva Heger[SUP] 3 [/SUP], Elena Knops[SUP] 3 [/SUP], Clara Lehmann[SUP] 2 4 5 [/SUP], Jan Rybniker[SUP] 2 4 5 [/SUP], Philipp Schommers[SUP] 2 4 [/SUP], Dennis A Eichenauer[SUP] 2 6 7 [/SUP], Florian Kurth[SUP] 1 [/SUP], Michael Ramharter[SUP] 1 [/SUP], Rolf Kaiser[SUP] 3 [/SUP], Udo Holtick[SUP] 2 6 [/SUP], Florian Klein[SUP] 3 4 5 [/SUP], Norma Jung[SUP] 2 [/SUP], Veronica Di Cristanziano[SUP] 3 [/SUP]
Affiliations
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global health emergency. To improve the understanding of the systemic component of SARS-CoV-2, we investigated if viral load dynamics in plasma and respiratory samples are associated with antibody response and severity of coronavirus disease 2019 (COVID-19). SARS-CoV-2 RNA was found in plasma samples from 14 (44%) out of 32 patients. RNAemia was detected in 5 out of 6 fatal cases. Peak IgG values were significantly lower in mild/moderate than in severe (0.6 (interquartile range, IQR, 0.4-3.2) vs. 11.8 (IQR, 9.9-13.0), adjusted p = 0.003) or critical cases (11.29 (IQR, 8.3-12.0), adjusted p = 0.042). IgG titers were significantly associated with virus Ct (Cycle threshold) value in plasma and respiratory specimens ((? = 0.4, 95% CI (confidence interval, 0.2; 0.5), p < 0.001 and ? = 0.5, 95% CI (0.2; 0.6), p = 0.002). A classification as severe or a critical case was additionally inversely associated with Ct values in plasma in comparison to mild/moderate cases (? = -3.3, 95% CI (-5.8; 0.8), p = 0.024 and ? = -4.4, 95% CI (-7.2; 1.6), p = 0.007, respectively). Based on the present data, our hypothesis is that the early stage of SARS-CoV-2 infection is characterized by a primary RNAemia, as a potential manifestation of a systemic infection. Additionally, the viral load in plasma seems to be associated with a worse disease outcome.
Keywords: SARS-CoV-2; antibodies; blood; dynamics; humoral response; seroconversion; viral load; viremia.
. 2020 Sep 18;12(9):E1045.
doi: 10.3390/v12091045.
RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients
Kirsten Alexandra Eberhardt[SUP] 1 [/SUP], Charlotte Meyer-Schwickerath[SUP] 2 [/SUP], Eva Heger[SUP] 3 [/SUP], Elena Knops[SUP] 3 [/SUP], Clara Lehmann[SUP] 2 4 5 [/SUP], Jan Rybniker[SUP] 2 4 5 [/SUP], Philipp Schommers[SUP] 2 4 [/SUP], Dennis A Eichenauer[SUP] 2 6 7 [/SUP], Florian Kurth[SUP] 1 [/SUP], Michael Ramharter[SUP] 1 [/SUP], Rolf Kaiser[SUP] 3 [/SUP], Udo Holtick[SUP] 2 6 [/SUP], Florian Klein[SUP] 3 4 5 [/SUP], Norma Jung[SUP] 2 [/SUP], Veronica Di Cristanziano[SUP] 3 [/SUP]
Affiliations
- PMID: 32962125
- DOI: 10.3390/v12091045
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global health emergency. To improve the understanding of the systemic component of SARS-CoV-2, we investigated if viral load dynamics in plasma and respiratory samples are associated with antibody response and severity of coronavirus disease 2019 (COVID-19). SARS-CoV-2 RNA was found in plasma samples from 14 (44%) out of 32 patients. RNAemia was detected in 5 out of 6 fatal cases. Peak IgG values were significantly lower in mild/moderate than in severe (0.6 (interquartile range, IQR, 0.4-3.2) vs. 11.8 (IQR, 9.9-13.0), adjusted p = 0.003) or critical cases (11.29 (IQR, 8.3-12.0), adjusted p = 0.042). IgG titers were significantly associated with virus Ct (Cycle threshold) value in plasma and respiratory specimens ((? = 0.4, 95% CI (confidence interval, 0.2; 0.5), p < 0.001 and ? = 0.5, 95% CI (0.2; 0.6), p = 0.002). A classification as severe or a critical case was additionally inversely associated with Ct values in plasma in comparison to mild/moderate cases (? = -3.3, 95% CI (-5.8; 0.8), p = 0.024 and ? = -4.4, 95% CI (-7.2; 1.6), p = 0.007, respectively). Based on the present data, our hypothesis is that the early stage of SARS-CoV-2 infection is characterized by a primary RNAemia, as a potential manifestation of a systemic infection. Additionally, the viral load in plasma seems to be associated with a worse disease outcome.
Keywords: SARS-CoV-2; antibodies; blood; dynamics; humoral response; seroconversion; viral load; viremia.