High frequency of SARS-CoV-2 RNAemia and association with severe disease

Abstract

24Background: Detection of SARS-CoV-2 RNA in the blood, also known as RNAemia, has been 25 reported, but its prognostic implications are not well understood. This study aimed to determine 26 the frequency of SARS-CoV-2 RNA in plasma and its association with the clinical severity of 27 Methods: An analytical cross-sectional study was performed in a single-center tertiary care 29 institution in northern California and included consecutive inpatients and outpatients with COVID-30 19 confirmed by detection of SARS-CoV-2 RNA in nasopharyngeal swab specimens. The 31 prevalence of SARS CoV-2 RNAemia and the strength of its association with clinical severity 32 variables were examined and included the need for transfer to an intensive care unit (ICU), 33 mechanical ventilation and 30-day all-cause mortality. 34 Results: Paired nasopharyngeal and plasma samples were included from 85 patients. The overall 35 median age was 55 years, and individuals with RNAemia were older than those with undetectable 36 SARS-CoV-2 RNA in plasma (63 vs 50 years; p=0.001). Comorbidities were frequent including 37 obesity (37.7%), hypertension (30.6%) and diabetes mellitus (22.4%). RNAemia was detected in 38 a total of 28/85 (32.9%) individual patients, including 22/28 (78.6%) who required hospital 39 admission. RNAemia was detected more frequently in individuals who developed severe disease 40 including the need for ICU transfer (32.1% vs 14.0%; p=0.05), mechanical ventilation (21.4% vs 41 3.5%; p=0.01) and 30-day all-cause mortality (14.3% vs 0%; p=0.01). No association was detected 42 between RNAemia and estimated levels of viral RNA in the nasopharynx. An additional 121 43 plasma samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was 44 detected for a maximum duration of 10 days.45 All rights reserved. No reuse allowed without permission.was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. Conclusion:This study demonstrated a high proportion of SARS-CoV-2 RNAemia, and an 46 association between RNAemia and clinical severity suggesting the potential utility of plasma viral 47 testing as a prognostic indicator for COVID-19. 48All rights reserved. No reuse allowed without permission.was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.(NP) swab samples. Preliminary data suggest that severe acute respiratory syndrome coronavirus 51 2 (SARS-CoV-2) RNA may also be detected in plasma and serum. 1,2 However, the frequency and 52 prognostic implication of viral RNA detection in these sample types is not fully understood. We 53 aim to investigate the association between detectable SARS-CoV-2 RNA in nasopharyngeal swab 54 and plasma samples, and to describe clinical implications of viral RNA detection in plasma. 55 56 Methods 57 We performed a cross-sectional study at the Stanford Health Care (SHC) Clinical Virology 58 Laboratory, which serves adult and pediatric tertiar...

Evaluation of two RT-PCR techniques for SARS-CoV-2 RNA detection in serum for microbiological diagnosis

“…In our study the viraemia's percentage showed significant differences (p≤0,001) in ICU patients respect patients admitted in the ward with the two rRT-PCR assays; supporting previous studies which indicate that presence of SARS-CoV-2 RNA in serum samples is more common in critical patients and could be considerated a prognostic indicator (15)(16)(17).…”

SARS-CoV-2 Antibody Responses Correlate with Resolution of RNAemia But Are Short-Lived in Patients with Mild Illness

“…Viral RNAemia is detected in up to a third of COVID-19 patients, most often in patients with severe disease ( 3 , 19 ). EDTA plasma was available from all inpatients for SARS-CoV-2 rRT-PCR testing.…”

SARS-CoV-2 Spike Protein Interacts with Multiple Innate Immune Receptors

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