Severe Acute Respiratory Syndrome Coronavirus 2 RNA in Serum as Predictor of Severe Outcome in Coronavirus Disease 2019: A Retrospective Cohort Study

Abstract

Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19). This study aimed to determine if SARS-CoV-2 RNA in serum at admission correlated with clinical outcome in COVID-19. Methods COVID-19 patients admitted to the Infectious Diseases department of a tertiary level Swedish hospital, and sampled for SARS-CoV-2 RNA in serum at admission, April 10 to June 30 2020 were included in a cohort. Primary outcomes were day 28 all-cause mortality and progress to critical disease. Results The cohort (N=167) consisted of 106 SARS-CoV-2 RNA serum negative and 61 positive patients. Median sampling time for initial SARS-CoV-2 in serum was 1 (IQR 1-2) day after admission corresponding to day 10 (IQR 8-12) after symptom onset. Median ages were 53 (IQR 44-67) and 63 (IQR 52-74) years for the PCR-negative and positive patients, respectively. In the serum PCR negative and positive groups 3/106 and 15/61 patients died, respectively. The hazard ratios for critical disease and all-cause mortality were 7.2 (95% CI 3.0-17) and 8.6 (95% CI 2.4-30), respectively for patients that were serum PCR positive compared to serum PCR negative. Conclusion: SARS-CoV-2 RNA in serum at hospital admission indicates a high-risk of progression to critical disease and death.

The Impact of Viremia on Organ Failure, Biomarkers and Mortality in a Swedish Cohort of Critically ill COVID-19 Patients

“…Our and other studies [21,22] have shown that RNAemia was a predictor of death. In this cohort the effect of RNAemia was not present when adjusting for age, a surrogate for pre COVID-19 risk of death.…”

Interleukin-8 as a Biomarker for Disease Prognosis of Coronavirus Disease-2019 Patients

“…Meanwhile, some researchers also tried to find predictors of COVID-19 disease prognosis. Although the viral load, viremia, and RNA in sera of SARS-CoV-2 correlated with the severe outcome in COVID-19 patients (17)(18)(19)(20), sensitive biomarkers representing the prognosis of COVID-19 patients are stilled lacked. SARS-CoV-2 infection induces exuberant inflammatory responses and increased secretion of interleukin-1b (IL-1b), interferon-g (IFN-g), interferon inducible protein 10 (IP-10), monocyte chemotactic protein 1 (MCP-1), interleukin-4 (IL-4), and IL-10.…”

SARS-CoV-2 in Spent Dialysate from Chronic Peritoneal Dialysis Patients with COVID-19

“…The findings corroborate previous results in 4 chronic PD patients reported by other groups 7,8 . To the best of our knowledge, the report by Only a small fraction of patients that tested positive for SARS-CoV-2 are viremic, and those are typically patients with severe COVID-19 symptoms [1][2][3][4] . With a size of 60 to 140 nanometers, SARS-CoV-2 could theoretically enter the peritoneal cavity via translocation from the blood 15,11 .…”

“…SARS-CoV-2 was also detected in blood of COVID-19 positive patients 1,2 . Viremia of SARS-CoV-2 has been proposed as a predictor of a severe clinical course 3,4 .…”