Abstract
Background: Coronavirus disease 2019 (COVID-19) is a global public health problem that has already caused more than 662 000 deaths worldwide. Although the clinical manifestations of COVID-19 are dominated by respiratory symptoms, some patients present other severe damage such as cardiovascular, renal and liver injury, and/or multiple organ failure, suggesting a spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in blood. Recent ultrasensitive polymerase chain reaction (PCR) technology now allows absolute quantification of nucleic acids in plasma. We intend to use the droplet-based digital PCR technology to obtain sensitive detection and precise quantification of plasma SARS-CoV-2 viral load (SARS-CoV-2 RNAemia) in hospitalized COVID-19 patients.
Methods: Fifty-eight consecutive COVID-19 patients with pneumonia 8 to 12 days after onset of symptoms and 12 healthy controls were analyzed. Disease severity was categorized as mild to moderate in 17 patients, severe in 16, and critical in 26. Plasma SARS-CoV-2 RNAemia was quantified by droplet digital Crystal Digital PCR next-generation technology (Stilla Technologies, Villejuif, France).
Results: Overall, SARS-CoV-2 RNAemia was detected in 43 (74.1%) patients. Prevalence of positive SARS-CoV-2 RNAemia correlated with disease severity, ranging from 53% in mild-to-moderate patients to 88% in critically ill patients (P = .036). Levels of SARS-CoV-2 RNAemia were associated with severity (P = .035). Among 9 patients who experienced clinical deterioration during follow-up, 8 had positive SARS-CoV-2 RNAemia at baseline, whereas only 1 critical patient with undetectable SARS-CoV-2 RNAemia at the time of analysis died at day 27.
Conclusion: SARS-CoV-2 RNAemia measured by droplet-based digital PCR constitutes a promising prognosis biomarker in COVID-19 patients.
Keywords: SARS-CoV-2 RNAaemia; biomarker; clinical severity; coronavirus disease 19 (COVID-19); droplet-based digital PCR.
【저자키워드】 Biomarker, Coronavirus disease 19 (COVID-19), Clinical severity, SARS-CoV-2 RNAaemia, droplet-based digital PCR., 【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, coronavirus, Biomarker, Prognosis, Pneumonia, severity, disease severity, droplet, severe acute respiratory syndrome Coronavirus, clinical manifestations, Spread, polymerase chain reaction, digital PCR, nucleic acid, PCR, Critically ill, Viral load, nucleic acids, Patient, Digital, death, Liver injury, France, Mild, plasma, Follow-up, multiple organ failure, quantification, Critical, moderate, patients, critically ill patients, COVID-19 patients, Blood, Clinical severity, Analysis, COVID-19 patient, Clinical deterioration, Mild-to-moderate, Organ failure, respiratory symptoms, health problem, mild to moderate, Chain Reaction, clinical manifestation, Critically ill patient, acute respiratory syndrome, hospitalized COVID-19 patients, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, global public health, healthy control, SARS-CoV-2 viral load, crystal, renal, positive, Clinical manifestations of COVID-19, recent, polymerase chain, analyzed, caused, died, onset of symptom, correlated, Level, quantified, baseline, undetectable, 【제목키워드】 coronavirus 2, RNA, clinical, respiratory, sensitive, LIGHT, Shed, value, Potential,