Background The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). Methods This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay. Results Most patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009). Conclusions COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.
【초록키워드】 COVID-19, neutralizing antibody, SARS-CoV-2, IgM, ARDS, coronavirus, intensive care, acute respiratory distress syndrome, Neutralizing antibodies, disease severity, Antiviral treatment, severe acute respiratory syndrome Coronavirus, polymerase chain reaction, enzyme-linked immunosorbent assay, RT-qPCR, survival, Viral, Antibody detection, anti-SARS-CoV-2 antibody, Viral load, RBD, serologic, oropharyngeal swab, Patient, Neutralizing, reverse transcription, SARS-CoV-2 RNA, respiratory, distribution, Quantitative, patients, serologic testing, biodistribution, antibody formation, acute respiratory distress, 30-Day mortality, retrospective, Concentration, Virus Disease, respiratory distress, Chain Reaction, reverse transcription quantitative polymerase chain reaction, Non-survivors, acute respiratory syndrome, acute respiratory syndrome coronavirus, tissue, acute respiratory syndrome coronavirus 2, Blood samples, enzyme, Most patients, oropharyngeal swabs, no difference, IgA antibodies, dialysate, high viral load, ICU treatment, intensive care treatment, SARS-CoV-2 viral load, severe ARDS, severe corona virus disease, Tracheal aspirates, blood sample, syndrome, single-center study, binding domain, positive, significantly lower, survivor, non-survivor, enzyme-linked immunosorbent, polymerase chain, Result, tested, collected, the patient, investigated, remained, detectable, Most patient, was performed, majority, suffered, tracheal, IgA antibody, accompanied, 【제목키워드】 SARS-CoV-2, cohort study, Serologic response,