Abstract
Background: Approximately 15-30% of hospitalized coronavirus disease 2019 (COVID-19) patients develop acute respiratory distress syndrome, systemic tissue injury, and/or multi-organ failure leading to death in around 45% of cases. There is a clear need for biomarkers that quantify tissue injury, predict clinical outcomes, and guide the clinical management of hospitalized COVID-19 patients.
Methods: We herein report the quantification by droplet-based digital polymerase chain reaction (ddPCR) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNAemia and the plasmatic release of a ubiquitous human intracellular marker, the ribonuclease P (RNase P) in order to evaluate tissue injury and cell lysis in the plasma of 139 COVID-19 hospitalized patients at admission.
Results: We confirmed that SARS-CoV-2 RNAemia was associated with clinical severity of COVID-19 patients. In addition, we showed that plasmatic RNase P RNAemia at admission was also highly correlated with disease severity (P < .001) and invasive mechanical ventilation status (P < .001) but not with pulmonary severity. Altogether, these results indicate a consequent cell lysis process in severe and critical patients but not systematically due to lung cell death. Finally, the plasmatic RNase P RNA value was also significantly associated with overall survival.
Conclusions: Viral and ubiquitous blood biomarkers monitored by ddPCR could be useful for the clinical monitoring and the management of hospitalized COVID-19 patients. Moreover, these results could pave the way for new and more personalized circulating biomarkers in COVID-19, and more generally in infectious diseases, specific from each patient organ injury profile.
Keywords: SARS-CoV-2 and RNAseP RNAemia; ddPCR; hospitalized COVID-19 patient; predictive and prognostic biomarkers; tissue/cell lysis biomarker.
【저자키워드】 ddPCR, SARS-CoV-2 and RNAseP RNAemia, hospitalized COVID-19 patient, predictive and prognostic biomarkers, tissue/cell lysis biomarker., 【초록키워드】 COVID-19, coronavirus disease, Prognostic biomarkers, SARS-CoV-2, Respiratory distress syndrome, Coronavirus disease 2019, coronavirus, Biomarker, Biomarkers, Infectious diseases, Diseases, Hospitalized, acute respiratory distress syndrome, severity, disease severity, severe and critical patients, severe acute respiratory syndrome Coronavirus, clinical outcomes, RNA, polymerase chain reaction, survival, Viral, management, Patient, death, Clinical management, plasma, prognostic, respiratory, quantification, Admission, Critical, predict, COVID-19 patients, Blood, acute respiratory distress, marker, Clinical severity, Invasive mechanical ventilation, tissue injury, Predictive, respiratory distress, Chain Reaction, acute respiratory syndrome, hospitalized COVID-19 patients, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, overall survival, syndrome, organ injury, multi-organ failure, circulating, RNase P, cell lysis, clinical monitoring, hospitalized COVID-19, lung cell, RNAseP, polymerase chain, develop, evaluate, significantly, addition, hospitalized patient, correlated, 【제목키워드】 COVID-19, RNA,