SARS-CoV-2 in Urine May Predict a Severe Evolution of COVID-19

Perrella, Alessandro; Brita, Mario; Coletta, Francesco; Cotena, Simona; Marco, GiamPaola De; Longobardi, A.; Sala, Crescenzo; Sannino, Dania; Tomasello, Antonio; Perrella, Marco; Russo, Giuseppe; Tarsitano, Marina; Chetta, Massimo; Monica, Matteo Della; Orlando, Valentina; Coscioni, Enrico; Villani, Romolo

doi:10.3390/jcm10184061

Cited by 8 publications

(10 citation statements)

References 22 publications

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“…On the other hand, some studies have indicated that, in addition to being a rare occurrence, urinary viral secretion was not associated with acute kidney injury or severity of COVID-19 disease [ 15 , 16 ]. However, several other studies have found that those subjects with SARS-CoV-2 in the urine at admission to hospital and its persistence during hospitalization had more severe COVID-19 [ 18 , 19 ] and a worse clinical course [ 19 ]. Thus, there are different studies with conflicting results regarding the presence of SARS-CoV-2 RNA in urine and the progression of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the few methodologically sound studies using RT-qPCR for detection included a small number of specimens and found a very low rate of positivity [ 14 ]. On the other hand, there are still conflicting opinions as to whether the presence of the virus in urine can be an indicator of severity or worse prognosis of the disease [ 15 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Detection of SARS-CoV-2 RNA in Urine by RT-LAMP: A Very Rare Finding

Diego

Fernández‐Soto

Muñoz‐Bellido

et al. 2021

JCM

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Detection of SARS-CoV-2 is routinely performed in naso/oropharyngeal swabs samples from patients via RT-qPCR. The RT-LAMP technology has also been used for viral RNA detection in respiratory specimens with both high sensitivity and specificity. Recently, we developed a novel RT-LAMP test for SARS-CoV-2 RNA detection in nasopharyngeal swab specimens (named, N15-RT-LAMP) that can be performed as a single-tube colorimetric method, in a real-time platform, and as dry-LAMP. To date, there has been very little success in detecting SARS-CoV-2 RNA in urine by RT-qPCR, and the information regarding urine viral excretion is still scarce and not comprehensive. Here, we tested our N15-RT-LAMP on the urine of 300 patients admitted to the Hospital of Salamanca, Spain with clinical suspicion of COVID-19, who had a nasopharyngeal swab RT-qPCR-positive (n = 100), negative (n = 100), and positive with disease recovery (n = 100) result. The positive group was also tested by RT-qPCR for comparison to N15-RT-LAMP. Only a 4% positivity rate was found in the positive group via colorimetric N15-RT-LAMP and 2% via RT-qPCR. Our results are consistent with those obtained in other studies that the presence of SARS-CoV-2 RNA in urine is a very rare finding. The absence of SARS-CoV-2 RNA in urine in the recovered patients might suggest that the urinary route is very rarely used for viral particle clearance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Detection of SARS-CoV-2 RNA in Urine by RT-LAMP: A Very Rare Finding

Diego

Fernández‐Soto

Muñoz‐Bellido

et al. 2021

JCM

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“…A Ct value of less than 30, which indicated an increased viral load, was used to determine infectivity. 14,15…”

Section: Methodsmentioning

confidence: 99%

“…A Ct value of less than 30, which indicated an increased viral load, was used to determine infectivity. 14,15 Were considered as fully positive only results when all 4 genes found to be amplified by Rt-PCR while in all other case results were considered doubt and repeated. 14,15 Participant consent was given for the release of all SARS-CoV-2 PCR test results before or after vaccination.…”

Section: Study Design and Cohort Selectionmentioning

confidence: 99%

“…14,15 Were considered as fully positive only results when all 4 genes found to be amplified by Rt-PCR while in all other case results were considered doubt and repeated. 14,15 Participant consent was given for the release of all SARS-CoV-2 PCR test results before or after vaccination. All positive participants were followed-up until negative PCR test.…”

Section: Study Design and Cohort Selectionmentioning

confidence: 99%

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SARS-CoV-2 Infection Breakthrough among the non-vaccinated and vaccinated: a Real World Evidence study based on Big Data

Perrella

BIsogno

D’Argenzio

et al. 2022

Preprint

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Background: SARS-CoV-2 infection after vaccination can occur because COVID-19 vaccines do not offer 100% protection. The aim of this study was to assess vaccination coverage among people nasopharyngeal swabs, disease symptoms and type of hospitalisation (Intensive Care Unit) between the non-vaccinated and the effective dose vaccinated and to evaluate vaccination trend over time. Methods: A retrospective cohort study was carried out among people tested positive for COVID-19 in Campania Region using collected information from Health Information System of Campania Region (Sinfonia). The status of vaccination was assess according to the following timetable: non-vaccinated; Ineffective dose vaccination; Effective dose vaccination. Univariate and multivariate logistic regression models were conducted to evaluate the association between Intensive Care Unit (ICU) to COVID-19 and gender, age groups and vaccine. To determine vaccine coverage in subjects who received an effective dose, trend changes over time were investigated using segmented linear regression models and breakpoints estimations. Vaccination coverage was assessed by analysing the trend in the percentage of covid 19 positive subjects in the 9 months after vaccination with an effective dose stratified by age group and type of vaccine. Statistical analyses were performed using R platform Results: A significant association with the risk of hospitalisation in Intensive Care Unit was the vaccination status of the subjects: subjects with ineffective dose (adjusted OR: 3.68) and subjects no-vaccination (adjusted OR: 7.14) were at three- and seven-times higher risk of hospitalisation in Intensive Care Unit, respectively, than subjects with an effective dose. Regarding subjects with an effective dose of vaccine, the vaccine's ability to protect against infection in the months following vaccination decreased. The first breakpoints is evident five months after vaccination (β =1.441, p<0.001). This increase was most evident after the seventh month after vaccination (β =3.110, p<0.001). Conclusions: COVID19 vaccines protect from symptomatic infection by significantly reducing the risk of ICU hospitalization for severe disease. However, it seems they have trend to decrease their fully protection against SARS-COV-2 after five months regardless age, sex or type of vaccine. Therefore it seems clear that those not undergoing vaccine had higher risk to develop clinically significant disease and being at risk of ICU stay. Thus, considering highest percentage of asymptomatic patients and that few data about their capacity to transmit SARS-CoV-2, third dose vaccination should be introduced as soon as possible, Finally, a surveillance approach based on the use of integrated BIG Data system to match all clinical conditions too, offer a precise and real analysis with low incidence of errors in the categorization of subjects.

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