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. 2021 May 4;72(9):e291-e295.
doi: 10.1093/cid/ciaa1054.

High Frequency of SARS-CoV-2 RNAemia and Association With Severe Disease

Catherine A Hogan  1   2 , Bryan A Stevens  1   2 , Malaya K Sahoo  1 , ChunHong Huang  1 , Natasha Garamani  1 , Saurabh Gombar  1 , Fumiko Yamamoto  1 , Kanagavel Murugesan  1 , Jason Kurzer  1 , James Zehnder  1 , Benjamin A Pinsky  1   2   3
Affiliations

High Frequency of SARS-CoV-2 RNAemia and Association With Severe Disease

Catherine A Hogan et al. Clin Infect Dis. .

Abstract

Background: Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in blood, also known as RNAemia, has been reported, but its prognostic implications are poorly understood. This study aimed to determine the frequency of SARS-CoV-2 RNA in plasma and its association with coronavirus disease 2019 (COVID-19) clinical severity.

Methods: An analytical cross-sectional study was performed in a single-center tertiary care institution and included consecutive inpatients and outpatients with confirmed COVID-19. The prevalence of SARS CoV-2 RNAemia and the strength of its association with clinical severity variables were examined and included intensive care unit (ICU) admission, invasive mechanical ventilation, and 30-day all-cause mortality.

Results: Paired nasopharyngeal and plasma samples were included from 85 patients. The median age was 55 years, and individuals with RNAemia were older than those with undetectable SARS-CoV-2 RNA in plasma (63 vs 50 years; P = .04). Comorbidities were frequent including obesity (37.6%), hypertension (30.6%), and diabetes mellitus (22.4%). RNAemia was detected in 28/85 (32.9%) of patients, including 22/28 (78.6%) who required hospitalization. In models adjusted for age, RNAemia was detected more frequently in individuals who developed severe disease including ICU admission (32.1 vs 14.0%; P = .04) and invasive mechanical ventilation (21.4% vs 3.5%; P = .02). All 4 deaths occurred in individuals with detectable RNAemia. An additional 121 plasma samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was detected for a maximum duration of 10 days.

Conclusions: This study demonstrated a high proportion of SARS-CoV-2 RNAemia, and an association between RNAemia and clinical severity suggesting the potential utility of plasma viral testing as a prognostic indicator for COVID-19.

Keywords: COVID-19; RNAemia; SARS-CoV-2; blood; severity.

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Figures

Figure 1.
Figure 1.
Longitudinal SARS-CoV-2 nasopharyngeal and plasma data for individuals with 5 or more samples including at least 1 sample collected before ICU admission. The dotted background line represents the real-time reverse transcription polymerase chain reaction threshold. Black circles represent the cycle threshold result of plasma samples tested for SARS-CoV-2. Red dots represent the cycle threshold result of nasopharyngeal samples tested for SARS-CoV-2. The purple rectangles represent the time of hospital admission. The light blue rectangles represent the timeline of ICU stay. Patient identification numbers appear on the right. Abbreviations: ICU, intensive care unit; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2.
See this image and copyright information in PMC

References

    1. Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA 2020; 323:1843–4. - PMC - PubMed
    1. Zhang W, Du RH, Li B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect 2020; 9:386–9. - PMC - PubMed
    1. Hogan CA, Sahoo MK, Pinsky BA. Sample pooling as a strategy to detect community transmission of SARS-CoV-2. JAMA 2020; 323:1967–9. - PMC - PubMed
    1. Corman VM, Landt O, Kaiser M, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill 2020; 25:1–8. - PMC - PubMed
    1. U.S. Food and Drug Administration. Stanford health care clinical virology laboratory SARS-CoV-2 test EUA summary Available at: https://www.fda.gov/media/136818/download. Accessed 7 May 2020.