Quantitative assessment of SARS‐CoV‐2 RNAemia and outcome in patients with coronavirus disease 2019

Abstract

The disease spectrum of coronavirus disease 2019 (COVID-19) varies from asymptomatic infection to critical illness and death. Identification of prognostic markers is vital for predicting progression and clinical practice. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, known as RNAemia, has been detected in the blood.However, the potential clinical value of SARS-CoV-2 RNAemia remains unknown. We, therefore, conducted a meta-analysis using a random-effects model to estimate the pooled prevalence of SARS-CoV-2 RNAemia as well as summary strength of RNAemia in association with disease severity and unfavorable clinical outcomes. A total of 21 studies involving 2181 patients were included. SARS-CoV-2 RNAemia in COVID-19 patients varied from 9.4% to 74.1%, with a pooled estimate of 34% (95% confidene interval [CI]: 26%-43%). Overall, SARS-CoV-2 RNAemia was associated with COVID-19 severity with odds ratio (OR) of 5.43 (95% CI: 3.46-8.53). In addition, SARS-CoV-2 RNAemia was a significant risk factor for unfavorable clinical outcomes (OR = 6.54, 95% CI: 3.82-11.21).The summary OR was 4.28 (95% CI: 2.20-8.33) for intensive care unit (ICU) admission, 11.07 (95% CI: 5.60-21.88) for mortality. Furthermore, RNAemia was also a significant risk factor for invasive mechanical ventilation and multiple organ failure. SARS-CoV-2 RNAemia is associated with disease severity, ICU admission, death in COVID-19, and may serve as a clinical predictor. More prospective trials in evaluating the potential of SARS-CoV-2 RNAemia as a prognostic indicator are necessary.

SARS‐CoV‐2 RNAaemia in children: An Iranian referral hospital‐based study

“…Serum/ plasma SARS-CoV-2 viral RNA was detected in 9.4% to 74.1%, with a pooled estimate of 34% (95% CI, 26%-43%) in patients with a positive nasopharyngeal swab RT-PCR test. [7][8][9][10]17,18 Our results show that the symptoms that are more commonly found in cases with COVID-19 (fever, cough, tachypnea, and vomiting), were found at a higher percentage in the patients with SARS-CoV-2 RNAaemia. Less commonly observed symptoms (sore throat, chest pain, rhinorrhea, diarrhea, abdominal pain, and headache), were rare or not found in both the negative and positive PCR blood test groups.…”

Two Patients With Severe COVID Pneumonia Treated With the Seraph-100 Microbind Affinity Blood Filter

“…Viremia has been independently correlated with disease severity and active clearance of viral particles is a second potential mechanism for effective therapy with Seraph100 hemoperfusion. 20 Prior research supports a direct role for heparin sulfate in SARS-CoV-2 cellular attachment and Figure 2. D-dimer values peaked at 7.1 μg/mL-FEU prior to Seraph100 treatment, declining to 2.08 μg/mL-FEU by discharge; CRP values peaked at 7.1 mg/dL prior to Seraph100 treatment, declining to 1.37 mg/dL by discharge.…”

SARS‐CoV‐2 RNAemia with a higher nasopharyngeal viral load is strongly associated with disease severity and mortality in patients with COVID‐19

“… 11 Recent studies demonstrated that RNAemia is associated with disease severity and unfavorable clinical outcomes. 12 , 13 This suggests that extra‐respiratory spread of SARS‐CoV‐2 contributes to systemic inflammatory responses, which are an important factor in the systemic pathogenesis of COVID‐19, including thrombosis and coagulopathy. 13 , 14…”

“… 12 , 13 This suggests that extra‐respiratory spread of SARS‐CoV‐2 contributes to systemic inflammatory responses, which are an important factor in the systemic pathogenesis of COVID‐19, including thrombosis and coagulopathy. 13 , 14…”