RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients

TY - JOUR

T1 - RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients

AU - Eberhardt, Kirsten Alexandra

AU - Meyer-Schwickerath, Charlotte

AU - Heger, Eva

AU - Knops, Elena

AU - Lehmann, Clara

AU - Rybniker, Jan

AU - Schommers, Philipp

AU - Eichenauer, Dennis A.

AU - Kurth, Florian

AU - Ramharter, Michael

AU - Kaiser, Rolf

AU - Holtick, Udo

AU - Klein, Florian

AU - Jung, Norma

AU - Di Cristanziano, Veronica

N1 - Funding Information: We are thankful to the patients who contributed to this study. Publisher Copyright: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/9/18

Y1 - 2020/9/18

N2 - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global health emergency. To improve the understanding of the systemic component of SARS-CoV-2, we investigated if viral load dynamics in plasma and respiratory samples are associated with antibody response and severity of coronavirus disease 2019 (COVID-19). SARS-CoV-2 RNA was found in plasma samples from 14 (44%) out of 32 patients. RNAemia was detected in 5 out of 6 fatal cases. Peak IgG values were significantly lower in mild/moderate than in severe (0.6 (interquartile range, IQR, 0.4–3.2) vs. 11.8 (IQR, 9.9–13.0), adjusted p = 0.003) or critical cases (11.29 (IQR, 8.3–12.0), adjusted p = 0.042). IgG titers were significantly associated with virus Ct (Cycle threshold) value in plasma and respiratory specimens ((ß = 0.4, 95% CI (confidence interval, 0.2; 0.5), p < 0.001 and ß = 0.5, 95% CI (0.2; 0.6), p = 0.002). A classification as severe or a critical case was additionally inversely associated with Ct values in plasma in comparison to mild/moderate cases (ß = −3.3, 95% CI (−5.8; 0.8), p = 0.024 and ß = −4.4, 95% CI (−7.2; 1.6), p = 0.007, respectively). Based on the present data, our hypothesis is that the early stage of SARS-CoV-2 infection is characterized by a primary RNAemia, as a potential manifestation of a systemic infection. Additionally, the viral load in plasma seems to be associated with a worse disease outcome.

AB - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global health emergency. To improve the understanding of the systemic component of SARS-CoV-2, we investigated if viral load dynamics in plasma and respiratory samples are associated with antibody response and severity of coronavirus disease 2019 (COVID-19). SARS-CoV-2 RNA was found in plasma samples from 14 (44%) out of 32 patients. RNAemia was detected in 5 out of 6 fatal cases. Peak IgG values were significantly lower in mild/moderate than in severe (0.6 (interquartile range, IQR, 0.4–3.2) vs. 11.8 (IQR, 9.9–13.0), adjusted p = 0.003) or critical cases (11.29 (IQR, 8.3–12.0), adjusted p = 0.042). IgG titers were significantly associated with virus Ct (Cycle threshold) value in plasma and respiratory specimens ((ß = 0.4, 95% CI (confidence interval, 0.2; 0.5), p < 0.001 and ß = 0.5, 95% CI (0.2; 0.6), p = 0.002). A classification as severe or a critical case was additionally inversely associated with Ct values in plasma in comparison to mild/moderate cases (ß = −3.3, 95% CI (−5.8; 0.8), p = 0.024 and ß = −4.4, 95% CI (−7.2; 1.6), p = 0.007, respectively). Based on the present data, our hypothesis is that the early stage of SARS-CoV-2 infection is characterized by a primary RNAemia, as a potential manifestation of a systemic infection. Additionally, the viral load in plasma seems to be associated with a worse disease outcome.

KW - Antibodies

KW - Blood

KW - Dynamics

KW - Humoral response

KW - SARS-CoV-2

KW - Seroconversion

KW - Viral load

KW - Viremia

UR - http://www.scopus.com/inward/record.url?scp=85091585873&partnerID=8YFLogxK

U2 - 10.3390/v12091045

DO - 10.3390/v12091045

M3 - SCORING: Journal article

C2 - 32962125

AN - SCOPUS:85091585873

VL - 12

JO - VIRUSES-BASEL

JF - VIRUSES-BASEL

SN - 1999-4915

IS - 9

M1 - 1045

ER -