SARS-CoV-2 Blood RNA Load Predicts Outcome in Critically Ill COVID-19 Patients
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SARS-CoV-2 Blood RNA Load Predicts Outcome in Critically Ill COVID-19 Patients. / Heinrich, Fabian; Nentwich, Michael F; Bibiza-Freiwald, Eric; Nörz, Dominik; Roedl, Kevin; Christner, Martin; Hoffmann, Armin; Olearo, Flaminia; Kluge, Stefan; Aepfelbacher, Martin; Wichmann, Dominic; Lütgehetmann, Marc; Pfefferle, Susanne.
in: OPEN FORUM INFECT DI, Jahrgang 8, Nr. 11, ofab509, 11.2021.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - SARS-CoV-2 Blood RNA Load Predicts Outcome in Critically Ill COVID-19 Patients
AU - Heinrich, Fabian
AU - Nentwich, Michael F
AU - Bibiza-Freiwald, Eric
AU - Nörz, Dominik
AU - Roedl, Kevin
AU - Christner, Martin
AU - Hoffmann, Armin
AU - Olearo, Flaminia
AU - Kluge, Stefan
AU - Aepfelbacher, Martin
AU - Wichmann, Dominic
AU - Lütgehetmann, Marc
AU - Pfefferle, Susanne
PY - 2021/11
Y1 - 2021/11
N2 - Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA loads in patient specimens may act as a clinical outcome predictor in critically ill patients with coronavirus disease 2019 (COVID-19).Methods: We evaluated the predictive value of viral RNA loads and courses in the blood compared with the upper and lower respiratory tract loads of critically ill COVID-19 patients. Daily specimen collection and viral RNA quantification by reverse transcription quantitative polymerase chain reaction were performed in all consecutive 170 COVID-19 patients between March 2020 and February 2021 during the entire intensive care unit (ICU) stay (4145 samples analyzed). Patients were grouped according to their 90-day outcome as survivors (n=100) or nonsurvivors (n=70).Results: In nonsurvivors, blood SARS-CoV-2 RNA loads were significantly higher at the time of admission to the ICU (P=.0009). Failure of blood RNA clearance was observed in 33/50 (66%) of the nonsurvivors compared with 12/64 (19%) survivors (P<.0001). As determined by multivariate analysis, taking sociodemographic and clinical parameters into account, blood SARS-CoV-2 RNA load represents a valid and independent predictor of outcome in critically ill COVID-19 patients (odds ratio [OR; log10], 0.23; 95% CI, 0.12-0.42; P<.0001), with a significantly higher effect for survival compared with respiratory tract SARS-CoV-2 RNA loads (OR [log10], 0.75; 95% CI, 0.66-0.85; P<.0001). Blood RNA loads exceeding 2.51×103 SARS-CoV-2 RNA copies/mL were found to indicate a 50% probability of death. Consistently, 29/33 (88%) nonsurvivors with failure of virus clearance exceeded this cutoff value constantly.Conclusions: Blood SARS-CoV-2 load is an important independent outcome predictor and should be further evaluated for treatment allocation and patient monitoring.
AB - Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA loads in patient specimens may act as a clinical outcome predictor in critically ill patients with coronavirus disease 2019 (COVID-19).Methods: We evaluated the predictive value of viral RNA loads and courses in the blood compared with the upper and lower respiratory tract loads of critically ill COVID-19 patients. Daily specimen collection and viral RNA quantification by reverse transcription quantitative polymerase chain reaction were performed in all consecutive 170 COVID-19 patients between March 2020 and February 2021 during the entire intensive care unit (ICU) stay (4145 samples analyzed). Patients were grouped according to their 90-day outcome as survivors (n=100) or nonsurvivors (n=70).Results: In nonsurvivors, blood SARS-CoV-2 RNA loads were significantly higher at the time of admission to the ICU (P=.0009). Failure of blood RNA clearance was observed in 33/50 (66%) of the nonsurvivors compared with 12/64 (19%) survivors (P<.0001). As determined by multivariate analysis, taking sociodemographic and clinical parameters into account, blood SARS-CoV-2 RNA load represents a valid and independent predictor of outcome in critically ill COVID-19 patients (odds ratio [OR; log10], 0.23; 95% CI, 0.12-0.42; P<.0001), with a significantly higher effect for survival compared with respiratory tract SARS-CoV-2 RNA loads (OR [log10], 0.75; 95% CI, 0.66-0.85; P<.0001). Blood RNA loads exceeding 2.51×103 SARS-CoV-2 RNA copies/mL were found to indicate a 50% probability of death. Consistently, 29/33 (88%) nonsurvivors with failure of virus clearance exceeded this cutoff value constantly.Conclusions: Blood SARS-CoV-2 load is an important independent outcome predictor and should be further evaluated for treatment allocation and patient monitoring.
U2 - 10.1093/ofid/ofab509
DO - 10.1093/ofid/ofab509
M3 - SCORING: Journal article
C2 - 34796247
VL - 8
JO - OPEN FORUM INFECT DI
JF - OPEN FORUM INFECT DI
SN - 2328-8957
IS - 11
M1 - ofab509
ER -