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Observational Study
. 2023 Apr 28;18(4):e0281052.
doi: 10.1371/journal.pone.0281052. eCollection 2023.

SARS-CoV-2 viremia and COVID-19 mortality: A prospective observational study

Andrea Giacomelli  1 , Elena Righini  2 , Valeria Micheli  3 , Pietro Pinoli  2 , Anna Bernasconi  2 , Alberto Rizzo  3 , Letizia Oreni  1 , Anna Lisa Ridolfo  1 , Spinello Antinori  1   4 , Stefano Ceri  2 , Giuliano Rizzardini  1
Affiliations
Observational Study

SARS-CoV-2 viremia and COVID-19 mortality: A prospective observational study

Andrea Giacomelli et al. PLoS One. .

Abstract

Background: SARS-CoV-2 viremia has been found to be a potential prognostic factor in patients hospitalized for COVID-19.

Objective: We aimed to assess the association between SARS-CoV-2 viremia and mortality in COVID-19 hospitalized patients during different epidemic periods.

Methods: A prospective COVID-19 registry was queried to extract all COVID-19 patients with an available SARS-CoV-2 viremia performed at hospital admission between March 2020 and January 2022. SARS-CoV-2 viremia was assessed by means of GeneFinderTM COVID-19 Plus RealAmp Kit assay and SARS-CoV-2 ELITe MGB® Kit using <45 cycle threshold to define positivity. Uni and multivariable logistic regression model were built to assess the association between SARS-CoV-2 positive viremia and death.

Results: Four hundred and forty-five out of 2,822 COVID-19 patients had an available SARS-CoV-2 viremia, prevalently males (64.9%) with a median age of 65 years (IQR 55-75). Patients with a positive SARS-CoV-2 viremia (86/445; 19.3%) more frequently presented with a severe or critical disease (67.4% vs 57.1%) when compared to those with a negative SARS-CoV-2 viremia. Deceased subjects (88/445; 19.8%) were older [75 (IQR 68-82) vs 63 (IQR 54-72)] and showed more frequently a detectable SARS-CoV-2 viremia at admission (60.2% vs 22.7%) when compared to survivors. In univariable analysis a positive SARS-CoV-2 viremia was associated with a higher odd of death [OR 5.16 (95% CI 3.15-8.45)] which was confirmed in the multivariable analysis adjusted for age, biological sex and, disease severity [AOR 6.48 (95% CI 4.05-10.45)]. The association between positive SARS-CoV-2 viremia and death was consistent in the period 1 February 2021-31 January 2022 [AOR 5.86 (95% CI 3.43-10.16)] and in subgroup analysis according to disease severity: mild/moderate [AOR 6.45 (95% CI 2.84-15.17)] and severe/critical COVID-19 patients [AOR 6.98 (95% CI 3.68-13.66)].

Conclusions: SARS-CoV-2 viremia resulted associated to COVID-19 mortality and should be considered in the initial assessment of COVID-19 hospitalized patients.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Stacked bar chart.
Number of hospital admissions with positive, negative viremia and with no viremia result.
See this image and copyright information in PMC

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