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Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study.
PLoS One. 2020; 15(11):e0242917.Plos

Abstract

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.

Authors+Show Affiliations

Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Institute for Virology and Immunobiology, University Hospital of Wuerzburg, Wuerzburg, Germany.Institute of Obstetrics and Gynecology, University Hospital of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Institute for Hygiene and Microbiology, University of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Institute for Virology and Immunobiology, University Hospital of Wuerzburg, Wuerzburg, Germany. Helmholtz Institute for RNA-based Infection Research (HIRI), Helmholtz-Center for Infection Research (HZI), Wuerzburg, Germany.Institute of Obstetrics and Gynecology, University Hospital of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33232382

Citation

Schlesinger, Tobias, et al. "Biodistribution and Serologic Response in SARS-CoV-2 Induced ARDS: a Cohort Study." PloS One, vol. 15, no. 11, 2020, pp. e0242917.
Schlesinger T, Weiβbrich B, Wedekink F, et al. Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study. PLoS One. 2020;15(11):e0242917.
Schlesinger, T., Weiβbrich, B., Wedekink, F., Notz, Q., Herrmann, J., Krone, M., Sitter, M., Schmid, B., Kredel, M., Stumpner, J., Dölken, L., Wischhusen, J., Kranke, P., Meybohm, P., & Lotz, C. (2020). Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study. PloS One, 15(11), e0242917. https://doi.org/10.1371/journal.pone.0242917
Schlesinger T, et al. Biodistribution and Serologic Response in SARS-CoV-2 Induced ARDS: a Cohort Study. PLoS One. 2020;15(11):e0242917. PubMed PMID: 33232382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study. AU - Schlesinger,Tobias, AU - Weiβbrich,Benedikt, AU - Wedekink,Florian, AU - Notz,Quirin, AU - Herrmann,Johannes, AU - Krone,Manuel, AU - Sitter,Magdalena, AU - Schmid,Benedikt, AU - Kredel,Markus, AU - Stumpner,Jan, AU - Dölken,Lars, AU - Wischhusen,Jörg, AU - Kranke,Peter, AU - Meybohm,Patrick, AU - Lotz,Christopher, Y1 - 2020/11/24/ PY - 2020/09/01/received PY - 2020/11/12/accepted PY - 2020/11/24/entrez PY - 2020/11/25/pubmed PY - 2020/11/25/medline SP - e0242917 EP - e0242917 JF - PloS one JO - PLoS One VL - 15 IS - 11 N2 - 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/33232382/Biodistribution_and_serologic_response_in_SARS_CoV_2_induced_ARDS:_A_cohort_study_ L2 - https://dx.plos.org/10.1371/journal.pone.0242917 DB - PRIME DP - Unbound Medicine ER -