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.
Keywords: COVID-19; SARS-CoV-2 RNAaemia; clinical severity; unfavorable outcome.
【저자키워드】 COVID-19, Clinical severity, SARS-CoV-2 RNAaemia, unfavorable outcome., 【초록키워드】 coronavirus disease, severe acute respiratory syndrome coronavirus 2, Meta-analysis, SARS-CoV-2, Critical illness, Coronavirus disease 2019, coronavirus, Mortality, intensive care, severity, disease severity, intensive care unit, COVID-19 severity, Prognostic markers, progression, outcome, risk factor, severe acute respiratory syndrome Coronavirus, clinical outcomes, ICU, RNA, Clinical outcome, Prevalence, Patient, asymptomatic infection, ICU admission, death, Prognostic marker, multiple organ failure, Admission, Critical, Blood, Clinical practice, association, Clinical severity, Invasive mechanical ventilation, Odds ratio, COVID-19 patient, identification, Disease spectrum, Prospective trial, acute respiratory syndrome, acute respiratory syndrome coronavirus, random-effects model, prognostic indicator, addition, conducted, death in COVID-19, with COVID-19, 【제목키워드】 SARS-CoV-2, outcome, Patient,