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. 2022 Mar:148:105120.
doi: 10.1016/j.jcv.2022.105120. Epub 2022 Feb 22.

Combining predictive markers for severe COVID-19: Torquetenovirus DNA load and SARS-CoV-2 RNAemia

Morgane Solis  1 , Floriane Gallais  1 , Sabrina Garnier-Kepka  2 , Nicolas Lefebvre  3 , Ilies Benotmane  4 , Pierre-Olivier Ludes  5 , Vincent Castelain  6 , Ferhat Meziani  7 , Sophie Caillard  8 , Olivier Collange  5 , Samira Fafi-Kremer  9
Affiliations

Combining predictive markers for severe COVID-19: Torquetenovirus DNA load and SARS-CoV-2 RNAemia

Morgane Solis et al. J Clin Virol. 2022 Mar.

Abstract

Rationale/objectives: SARS-CoV-2 is the cause of worldwide COVID-19, which severity has been linked to the immune and inflammatory response. Here, we investigate Torquetenovirus (TTV) DNA load - a marker reflecting the intensity of the overall immune response - as well as SARS-CoV-2 RNAemia and IgM/IgG antibodies in COVID-19-positive patients.

Methods: Two hundred and fifteen COVID-19-positive patients were enrolled, including 87 severe cases and 128 mild-moderate cases. SARS-CoV-2 RNAemia and IgM/IgG antibodies, as well as TTV DNA loads, were measured on longitudinal plasma samples.

Results: The rate of severe cases was higher in patients with low TTV DNA load in plasma considering a threshold of 700 copies/mL. In severe patients, SARS-CoV-2 RNAemia positivity rates were higher than those in mild-moderate cases at any timepoint. When combined, TTV DNA load and SARS-CoV-2 RNAemia allowed to predict the outcome of COVID-19 infection, with a higher risk (HR=12.4) of ICU admission in patients with low TTV DNA load and positive SARS-CoV-2 RNAemia.

Conclusions: TTV DNA load and SARS-CoV-2 RNAemia may be effective, non-invasive markers reflecting disease severity and poor outcome that could be conveniently measured in a clinical laboratory setting, as soon as COVID-19 diagnosis is made.

Keywords: Biomarker; COVID-19; Immunity.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Evolution of SARS-CoV-2 RNAemia prevalence in severe and non-severe cases. Samples were available at week one (W1) after symptom onset for 27 severe cases and 49 non-severe cases, at week two (W2) after symptom onset for 59 severe cases and 75 non-severe cases and at week three (W3) after symptom onset for 62 severe cases and 51 non-severe cases.
Fig. 2
Fig. 2
Distribution of severe COVID-19 cases according to TTV DNA load measured in the first or second week after symptom onset. Samples were available for 76 patients in the first week and 134 in the second. Severe cases rate was 2.23 times higher for patients with low TTV DNA load in the first week (p = 0.0069) and 1,83 times higher for patients with low TTV DNA load in the second week (p = 0.0017).
Fig. 3
Fig. 3
TTV DNA load and SARS-CoV-2 RNAemia help predict COVID-19 cases outcome. Kaplan-Meier curves represent ICU admission cumulative incidence according to TTV DNA load and SARS-CoV-2 RNAemia at patient admission in the emergency department. Numbers at risk are indicated at each timepoint.
See this image and copyright information in PMC

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