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Severe Acute Respiratory Syndrome Coronavirus 2 Viremia Is Associated With Coronavirus Disease 2019 Severity and Predicts Clinical Outcomes. | LitMetric

AI Article Synopsis

  • - SARS-CoV-2 viral RNA (vRNA) was found in the blood of COVID-19 patients, with detection rates varying significantly across different patient groups: 100% in ICU patients, around 52.6% for non-ICU hospitalized, and only 11.1% in outpatients.
  • - Higher levels of vRNA in the blood were linked to worse health outcomes, such as higher WHO scores at admission and increased mortality risk, particularly with levels above 6000 copies/mL.
  • - The presence of virus particles in plasma confirms that the detected vRNA is partly due to viremia, and while it correlates with disease severity and some inflammatory markers, it does not correlate with neutralizing antibody

Article Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA (vRNA) is detected in the bloodstream of some patients with coronavirus disease 2019 (COVID-19), but it is not clear whether this RNAemia reflects viremia (ie, virus particles) and how it relates to host immune responses and outcomes.

Methods: SARS-CoV-2 vRNA was quantified in plasma samples from observational cohorts of 51 COVID-19 patients including 9 outpatients, 19 hospitalized (non-intensive care unit [ICU]), and 23 ICU patients. vRNA levels were compared with cross-sectional indices of COVID-19 severity and prospective clinical outcomes. We used multiple imaging methods to visualize virions in plasma.

Results: SARS-CoV-2 vRNA was detected in plasma of 100%, 52.6%, and 11.1% of ICU, non-ICU, and outpatients, respectively. Virions were detected in plasma pellets using electron tomography and immunostaining. Plasma vRNA levels were significantly higher in ICU > non-ICU > outpatients (P < .0001); for inpatients, plasma vRNA levels were strongly associated with higher World Health Organization (WHO) score at admission (P = .01), maximum WHO score (P = .002), and discharge disposition (P = .004). A plasma vRNA level >6000 copies/mL was strongly associated with mortality (hazard ratio, 10.7). Levels of vRNA were significantly associated with several inflammatory biomarkers (P < .01) but not with plasma neutralizing antibody titers (P = .8).

Conclusions: Visualization of virus particles in plasma indicates that SARS-CoV-2 RNAemia is due, at least in part, to viremia. The levels of SARS-CoV-2 RNAemia correlate strongly with disease severity, patient outcome, and specific inflammatory biomarkers but not with neutralizing antibody titers.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9070832PMC
http://dx.doi.org/10.1093/cid/ciab686DOI Listing

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