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SARS-CoV-2 RNAemia with a higher nasopharyngeal viral load is strongly associated with disease severity and mortality in patients with COVID-19.
J Med Virol. 2022 01; 94(1):147-153.JM

Abstract

This study aimed to determine the frequency of SARS-CoV-2 RNA in serum and its association with the clinical severity of COVID-19. This retrospective cohort study performed at Toyama University Hospital included consecutive patients with confirmed COVID-19. The prevalence of SARS-CoV-2 RNAemia and the strength of its association with clinical severity variables were examined. Fifty-six patients were included in this study. RNAemia was detected in 19.6% (11/56) patients on admission, and subsequently in 1.0% (1/25), 50.0% (6/12), and 100.0% (4/4) moderate, severe, and critically ill patients, respectively. Patients with RNAemia required more frequent oxygen supplementation (90.0% vs. 13.3%), ICU admission (81.8% vs. 6.7%), and invasive mechanical ventilation (27.3% vs. 0.0%). Among patients with RNAemia, the median viral loads of nasopharyngeal (NP) swabs that were collected around the same time as the serum sample were significantly higher in critically ill (5.4 log10 copies/μl; interquartile range [IQR]: 4.2-6.3) than in moderate-severe cases (2.6 log10 copies/μl; [IQR: 1.1-4.5]; p = 0.030) and were significantly higher in nonsurvivors (6.2 log10 copies/μl [IQR: 6.0-6.5]) than in survivors (3.9 log10 copies/μl [IQR: 1.6-4.6]; p = 0.045). This study demonstrated a relatively high proportion of SARS-CoV-2 RNAemia and an association between RNAemia and clinical severity. Moreover, among the patients with RNAemia, the viral loads of NP swabs were correlated with disease severity and mortality, suggesting the potential utility of combining serum testing with NP tests as a prognostic indicator for COVID-19, with higher quality than each separate test.

Authors+Show Affiliations

Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Virology, Toyama Institute of Health, Toyama, Japan.Department of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

34411312

Citation

Kawasuji, Hitoshi, et al. "SARS-CoV-2 RNAemia With a Higher Nasopharyngeal Viral Load Is Strongly Associated With Disease Severity and Mortality in Patients With COVID-19." Journal of Medical Virology, vol. 94, no. 1, 2022, pp. 147-153.
Kawasuji H, Morinaga Y, Tani H, et al. SARS-CoV-2 RNAemia with a higher nasopharyngeal viral load is strongly associated with disease severity and mortality in patients with COVID-19. J Med Virol. 2022;94(1):147-153.
Kawasuji, H., Morinaga, Y., Tani, H., Yoshida, Y., Takegoshi, Y., Kaneda, M., Murai, Y., Kimoto, K., Ueno, A., Miyajima, Y., Fukui, Y., Kimura, M., Yamada, H., Sakamaki, I., & Yamamoto, Y. (2022). SARS-CoV-2 RNAemia with a higher nasopharyngeal viral load is strongly associated with disease severity and mortality in patients with COVID-19. Journal of Medical Virology, 94(1), 147-153. https://doi.org/10.1002/jmv.27282
Kawasuji H, et al. SARS-CoV-2 RNAemia With a Higher Nasopharyngeal Viral Load Is Strongly Associated With Disease Severity and Mortality in Patients With COVID-19. J Med Virol. 2022;94(1):147-153. PubMed PMID: 34411312.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - SARS-CoV-2 RNAemia with a higher nasopharyngeal viral load is strongly associated with disease severity and mortality in patients with COVID-19. AU - Kawasuji,Hitoshi, AU - Morinaga,Yoshitomo, AU - Tani,Hideki, AU - Yoshida,Yoshihiro, AU - Takegoshi,Yusuke, AU - Kaneda,Makito, AU - Murai,Yushi, AU - Kimoto,Kou, AU - Ueno,Akitoshi, AU - Miyajima,Yuki, AU - Fukui,Yasutaka, AU - Kimura,Miyuki, AU - Yamada,Hiroshi, AU - Sakamaki,Ippei, AU - Yamamoto,Yoshihiro, Y1 - 2021/08/25/ PY - 2021/08/02/received PY - 2021/08/14/accepted PY - 2021/8/20/pubmed PY - 2021/11/20/medline PY - 2021/8/19/entrez KW - COVID-19 KW - RNAemia KW - SARS-CoV-2 KW - mortality KW - nasopharyngeal viral load KW - severity SP - 147 EP - 153 JF - Journal of medical virology JO - J Med Virol VL - 94 IS - 1 N2 - This study aimed to determine the frequency of SARS-CoV-2 RNA in serum and its association with the clinical severity of COVID-19. This retrospective cohort study performed at Toyama University Hospital included consecutive patients with confirmed COVID-19. The prevalence of SARS-CoV-2 RNAemia and the strength of its association with clinical severity variables were examined. Fifty-six patients were included in this study. RNAemia was detected in 19.6% (11/56) patients on admission, and subsequently in 1.0% (1/25), 50.0% (6/12), and 100.0% (4/4) moderate, severe, and critically ill patients, respectively. Patients with RNAemia required more frequent oxygen supplementation (90.0% vs. 13.3%), ICU admission (81.8% vs. 6.7%), and invasive mechanical ventilation (27.3% vs. 0.0%). Among patients with RNAemia, the median viral loads of nasopharyngeal (NP) swabs that were collected around the same time as the serum sample were significantly higher in critically ill (5.4 log10 copies/μl; interquartile range [IQR]: 4.2-6.3) than in moderate-severe cases (2.6 log10 copies/μl; [IQR: 1.1-4.5]; p = 0.030) and were significantly higher in nonsurvivors (6.2 log10 copies/μl [IQR: 6.0-6.5]) than in survivors (3.9 log10 copies/μl [IQR: 1.6-4.6]; p = 0.045). This study demonstrated a relatively high proportion of SARS-CoV-2 RNAemia and an association between RNAemia and clinical severity. Moreover, among the patients with RNAemia, the viral loads of NP swabs were correlated with disease severity and mortality, suggesting the potential utility of combining serum testing with NP tests as a prognostic indicator for COVID-19, with higher quality than each separate test. SN - 1096-9071 UR - https://www.unboundmedicine.com/medline/citation/34411312/SARS_CoV_2_RNAemia_with_a_higher_nasopharyngeal_viral_load_is_strongly_associated_with_disease_severity_and_mortality_in_patients_with_COVID_19_ L2 - https://doi.org/10.1002/jmv.27282 DB - PRIME DP - Unbound Medicine ER -