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. 2021 Apr;159(4):1382-1386.
doi: 10.1016/j.chest.2020.11.071. Epub 2021 Jan 6.

Risk Factors of Viral RNAaemia and Its Association With Clinical Prognosis Among Patients With Severe COVID-19

Hui Li  1 , Xiaoying Gu  1 , Huadong Li  2 , Fengyun Gong  2 , Jiuyang Xu  3 , Yeming Wang  1 , Haibo Li  1 , Shunan Ruan  2 , Qingyu Yang  2 , Bin Cao  4
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Risk Factors of Viral RNAaemia and Its Association With Clinical Prognosis Among Patients With Severe COVID-19

Hui Li et al. Chest. 2021 Apr.
No abstract available

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Figures

Figure 1
Figure 1
A-F, Severe acute respiratory syndrome coronavirus 2 viral RNA detected via reverse transcription-polymerase chain reaction in plasma of the patients with coronavirus disease 2019 and viral RNAaemia. A, Each line represents a single viral RNAaemia positive patient, filled circles refer positive viral nucleic acids in plasma, and open circles represent no detectable viral RNA in plasma of patients with coronavirus disease 2019. Black up-pointing triangle (Δ) represents the time point of discharge. White up-pointing triangle (Δ) represents the time point of discharge and no detectable viral RNA in plasma. Black down-pointing triangle (▼) represents the time of death. White down-pointing triangle (▿) represents the time of death and no detectable viral RNA in plasma. B, Positive rate and C, dynamic change of viral load in plasma detected via reverse transcriptase-polymerase chain reaction among 192 patients with coronavirus disease 2019. The change of viral load and positive rate of RNAaemia were shown with time interval as 5 days (days after illness onset: day 5-9; day 10-14; day 15-19; day 20-24; day 25-29; day 30-34; day 35-39). Difference of viral load in D, throat swabs and E, anal swabs between the patients with viral RNAaemia and patients without viral RNAaemia. F, Correlation between viral RNAaemia and viral load in throat swabs and anal swabs. The dash line represents limit of detection.
Figure 2
Figure 2
A, Risk factors associated with viral RNAaemia in patients with severe coronavirus disease 2019. Age, sex, comorbidity (diabetes mellitus and malignancy), disease severity (seven-category scale at day 1 after being enrolled into lopinavir-ritonavir trial), and corticosteroids treatment before hospitalization were included in the model. Prior corticosteroid therapy for underlying diseases refers to therapy with corticosteroids dosage ≥15 mg of prednisone per day for at least 30 continuous days before the onset of illness. B, Association of viral RNAaemia with prognosis of patients with severe coronavirus disease 2019. Adjusted for age, sex, seven-category scale at baseline (day 1 after being enrolled into lopinavir-ritonavir trial), comorbidity, duration from illness onset to admission, antiviral treatment during hospitalization, and corticosteroid treatment before and during hospitalization. Acute kidney injury was identified according to Kidney Disease Improving Global Outcomes clinical practice guideline for acute kidney injury. Acute liver injury was considered as the levels of serum alanine aminotransferase above 3-fold of the upper limit of normal. ARDS was defined according to the interim guidance of the World Health Organization for severe acute respiratory syndrome coronavirus 2.
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