학술논문
Viral RNA load in plasma is associated with critical illness and a dysregulated host response in COVID-19
Document Type
article
Author
Jesús F. Bermejo-Martin; Milagros González-Rivera; Raquel Almansa; Dariela Micheloud; Ana P. Tedim; Marta Domínguez-Gil; Salvador Resino; Marta Martín-Fernández; Pablo Ryan Murua; Felipe Pérez-García; Luis Tamayo; Raúl Lopez-Izquierdo; Elena Bustamante; César Aldecoa; José Manuel Gómez; Jesús Rico-Feijoo; Antonio Orduña; Raúl Méndez; Isabel Fernández Natal; Gregoria Megías; Montserrat González-Estecha; Demetrio Carriedo; Cristina Doncel; Noelia Jorge; Alicia Ortega; Amanda de la Fuente; Félix del Campo; José Antonio Fernández-Ratero; Wysali Trapiello; Paula González-Jiménez; Guadalupe Ruiz; Alyson A. Kelvin; Ali Toloue Ostadgavahi; Ruth Oneizat; Luz María Ruiz; Iria Miguéns; Esther Gargallo; Ioana Muñoz; Sara Pelegrin; Silvia Martín; Pablo García Olivares; Jamil Antonio Cedeño; Tomás Ruiz Albi; Carolina Puertas; Jose Ángel Berezo; Gloria Renedo; Rubén Herrán; Juan Bustamante-Munguira; Pedro Enríquez; Ramón Cicuendez; Jesús Blanco; Jesica Abadia; Julia Gómez Barquero; Nuria Mamolar; Natalia Blanca-López; Luis Jorge Valdivia; Belén Fernández Caso; María Ángeles Mantecón; Anna Motos; Laia Fernandez-Barat; Ricard Ferrer; Ferrán Barbé; Antoni Torres; Rosario Menéndez; José María Eiros; David J. Kelvin
Source
Critical Care, Vol 24, Iss 1, Pp 1-13 (2020)
Subject
Language
English
ISSN
1364-8535
Abstract
Abstract Background COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response. Methods A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients. Results The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p