Severe Acute Respiratory Syndrome Coronavirus 2 RNAemia and Clinical Outcomes in Children With Coronavirus Disease 2019

Abstract

The burden of coronavirus disease 2019 (COVID-19) in children represents a fraction of cases worldwide, yet a subset of those infected are at risk for severe disease. We measured plasma severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in a cohort of 103 children hospitalized with COVID-19 with diverse clinical manifestations. SARS-CoV-2 RNAemia was detected in 27 (26%) of these children, lasted for a median of 6 (interquartile range, 2-9) days, and was associated with higher rates of oxygen administration, admission to the intensive care unit, and longer hospitalization.

Keywords: COVID-19; RNAemia; SARS-CoV-2; children; disease severity; infants; outcomes; viremia.

Figure 1.

Nasopharyngeal and plasma severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load (VL) in children and adolescents with coronavirus disease 2019 (COVID-19). A and C, The y-axis represents the reverse-transcription polymerase chain reaction cycle threshold (Ct) SARS-CoV-2 values in plasma samples from all children and adolescents with SARS-CoV-2 RNAemia (red dots) (A) and in those with symptomatic COVID-19 (C). B and D, Nasopharyngeal SARS-CoV-2 loads in all children and adolescents with RNAemia (blue dots) and without RNAemia (yellow dots) (B), and exclusively in children with symptomatic COVID-19 (D). Data represent median (interquartile range). Comparisons by Mann–Whitney rank test; ∗∗∗P < .001; ∗∗∗∗P < .0001.