Detection of SARS-CoV-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 patients
Abstract COVID-19 has overloaded national health services worldwide. Thus, early identification of patients at risk of poor outcomes is critical. Our objective was to analyse SARS-CoV-2 RNA detection in serum as a severity biomarker in COVID-19. Retrospective observational study including 193 patien...
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Nature Publishing Group
2021-06-01
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Series: | Scientific Reports |
Online Access: | https://doi.org/10.1038/s41598-021-92497-1 |
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DOAJ |
language |
English |
format |
Article |
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DOAJ |
author |
Diego A. Rodríguez-Serrano Emilia Roy-Vallejo Nelly D. Zurita Cruz Alexandra Martín Ramírez Sebastián C. Rodríguez-García Nuria Arevalillo-Fernández José María Galván-Román Leticia Fontán García-Rodrigo Lorena Vega-Piris Marta Chicot Llano David Arribas Méndez Begoña González de Marcos Julia Hernando Santos Ana Sánchez Azofra Elena Ávalos Pérez-Urria Pablo Rodriguez-Cortes Laura Esparcia Ana Marcos-Jimenez Santiago Sánchez-Alonso Irene Llorente Joan Soriano Carmen Suárez Fernández Rosario García-Vicuña Julio Ancochea Jesús Sanz Cecilia Muñoz-Calleja Rafael de la Cámara Alfonso Canabal Berlanga Isidoro González-Álvaro Laura Cardeñoso the REINMUN-COVID Group |
spellingShingle |
Diego A. Rodríguez-Serrano Emilia Roy-Vallejo Nelly D. Zurita Cruz Alexandra Martín Ramírez Sebastián C. Rodríguez-García Nuria Arevalillo-Fernández José María Galván-Román Leticia Fontán García-Rodrigo Lorena Vega-Piris Marta Chicot Llano David Arribas Méndez Begoña González de Marcos Julia Hernando Santos Ana Sánchez Azofra Elena Ávalos Pérez-Urria Pablo Rodriguez-Cortes Laura Esparcia Ana Marcos-Jimenez Santiago Sánchez-Alonso Irene Llorente Joan Soriano Carmen Suárez Fernández Rosario García-Vicuña Julio Ancochea Jesús Sanz Cecilia Muñoz-Calleja Rafael de la Cámara Alfonso Canabal Berlanga Isidoro González-Álvaro Laura Cardeñoso the REINMUN-COVID Group Detection of SARS-CoV-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 patients Scientific Reports |
author_facet |
Diego A. Rodríguez-Serrano Emilia Roy-Vallejo Nelly D. Zurita Cruz Alexandra Martín Ramírez Sebastián C. Rodríguez-García Nuria Arevalillo-Fernández José María Galván-Román Leticia Fontán García-Rodrigo Lorena Vega-Piris Marta Chicot Llano David Arribas Méndez Begoña González de Marcos Julia Hernando Santos Ana Sánchez Azofra Elena Ávalos Pérez-Urria Pablo Rodriguez-Cortes Laura Esparcia Ana Marcos-Jimenez Santiago Sánchez-Alonso Irene Llorente Joan Soriano Carmen Suárez Fernández Rosario García-Vicuña Julio Ancochea Jesús Sanz Cecilia Muñoz-Calleja Rafael de la Cámara Alfonso Canabal Berlanga Isidoro González-Álvaro Laura Cardeñoso the REINMUN-COVID Group |
author_sort |
Diego A. Rodríguez-Serrano |
title |
Detection of SARS-CoV-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 patients |
title_short |
Detection of SARS-CoV-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 patients |
title_full |
Detection of SARS-CoV-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 patients |
title_fullStr |
Detection of SARS-CoV-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 patients |
title_full_unstemmed |
Detection of SARS-CoV-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 patients |
title_sort |
detection of sars-cov-2 rna in serum is associated with increased mortality risk in hospitalized covid-19 patients |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-06-01 |
description |
Abstract COVID-19 has overloaded national health services worldwide. Thus, early identification of patients at risk of poor outcomes is critical. Our objective was to analyse SARS-CoV-2 RNA detection in serum as a severity biomarker in COVID-19. Retrospective observational study including 193 patients admitted for COVID-19. Detection of SARS-CoV-2 RNA in serum (viremia) was performed with samples collected at 48–72 h of admission by two techniques from Roche and Thermo Fischer Scientific (TFS). Main outcome variables were mortality and need for ICU admission during hospitalization for COVID-19. Viremia was detected in 50–60% of patients depending on technique. The correlation of Ct in serum between both techniques was good (intraclass correlation coefficient: 0.612; p < 0.001). Patients with viremia were older (p = 0.006), had poorer baseline oxygenation (PaO2/FiO2; p < 0.001), more severe lymphopenia (p < 0.001) and higher LDH (p < 0.001), IL-6 (p = 0.021), C-reactive protein (CRP; p = 0.022) and procalcitonin (p = 0.002) serum levels. We defined "relevant viremia" when detection Ct was < 34 with Roche and < 31 for TFS. These thresholds had 95% sensitivity and 35% specificity. Relevant viremia predicted death during hospitalization (OR 9.2 [3.8–22.6] for Roche, OR 10.3 [3.6–29.3] for TFS; p < 0.001). Cox regression models, adjusted by age, sex and Charlson index, identified increased LDH serum levels and relevant viremia (HR = 9.87 [4.13–23.57] for TFS viremia and HR = 7.09 [3.3–14.82] for Roche viremia) as the best markers to predict mortality. Viremia assessment at admission is the most useful biomarker for predicting mortality in COVID-19 patients. Viremia is highly reproducible with two different techniques (TFS and Roche), has a good consistency with other severity biomarkers for COVID-19 and better predictive accuracy. |
url |
https://doi.org/10.1038/s41598-021-92497-1 |
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doaj-97c9df8d7dbb43738740dce63bc7937c2021-06-27T11:32:46ZengNature Publishing GroupScientific Reports2045-23222021-06-0111111110.1038/s41598-021-92497-1Detection of SARS-CoV-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 patientsDiego A. Rodríguez-Serrano0Emilia Roy-Vallejo1Nelly D. Zurita Cruz2Alexandra Martín Ramírez3Sebastián C. Rodríguez-García4Nuria Arevalillo-Fernández5José María Galván-Román6Leticia Fontán García-Rodrigo7Lorena Vega-Piris8Marta Chicot Llano9David Arribas Méndez10Begoña González de Marcos11Julia Hernando Santos12Ana Sánchez Azofra13Elena Ávalos Pérez-Urria14Pablo Rodriguez-Cortes15Laura Esparcia16Ana Marcos-Jimenez17Santiago Sánchez-Alonso18Irene Llorente19Joan Soriano20Carmen Suárez Fernández21Rosario García-Vicuña22Julio Ancochea23Jesús Sanz24Cecilia Muñoz-Calleja25Rafael de la Cámara26Alfonso Canabal Berlanga27Isidoro González-Álvaro28Laura Cardeñoso29the REINMUN-COVID GroupIntensive Care Unit, Hospital Universitario La PrincesaInternal Medicine Department, Hospital Universitario La Princesa, IIS-IPMicrobiology Department, Hospital Universitario La Princesa, IIS-IPMicrobiology Department, Hospital Universitario La Princesa, IIS-IPRheumatology Department, Hospital Universitario La Princesa, IIS-IPIntensive Care Unit, Hospital Universitario La PrincesaInternal Medicine Department, Hospital Universitario La Princesa, IIS-IPMicrobiology Department, Hospital Universitario La Princesa, IIS-IPMethodology Unit, Biomedical Research Institute, Hospital Universitario La Princesa, IIS-IPIntensive Care Unit, Hospital Universitario La PrincesaAnaesthesiology Department, Hospital Universitario La Princesa, IIS-IPIntensive Care Unit, Hospital Universitario La PrincesaAnaesthesiology Department, Hospital Universitario La Princesa, IIS-IPPneumology Department, Hospital Universitario La Princesa, IIS-IPPneumology Department, Hospital Universitario La Princesa, IIS-IPInternal Medicine Department, Hospital Universitario La Princesa, IIS-IPImmunology Department, Hospital Universitario La Princesa, IIS-IPImmunology Department, Hospital Universitario La Princesa, IIS-IPImmunology Department, Hospital Universitario La Princesa, IIS-IPRheumatology Department, Hospital Universitario La Princesa, IIS-IPPneumology Department, Hospital Universitario La Princesa, IIS-IPInternal Medicine Department, Hospital Universitario La Princesa, IIS-IPRheumatology Department, Hospital Universitario La Princesa, IIS-IPPneumology Department, Hospital Universitario La Princesa, IIS-IPInternal Medicine Department, Hospital Universitario La Princesa, IIS-IPImmunology Department, Hospital Universitario La Princesa, IIS-IPHematology Department, Hospital Universitario La Princesa, IIS-IPIntensive Care Unit, Hospital Universitario La PrincesaRheumatology Department, Hospital Universitario La Princesa, IIS-IPMicrobiology Department, Hospital Universitario La Princesa, IIS-IPAbstract COVID-19 has overloaded national health services worldwide. Thus, early identification of patients at risk of poor outcomes is critical. Our objective was to analyse SARS-CoV-2 RNA detection in serum as a severity biomarker in COVID-19. Retrospective observational study including 193 patients admitted for COVID-19. Detection of SARS-CoV-2 RNA in serum (viremia) was performed with samples collected at 48–72 h of admission by two techniques from Roche and Thermo Fischer Scientific (TFS). Main outcome variables were mortality and need for ICU admission during hospitalization for COVID-19. Viremia was detected in 50–60% of patients depending on technique. The correlation of Ct in serum between both techniques was good (intraclass correlation coefficient: 0.612; p < 0.001). Patients with viremia were older (p = 0.006), had poorer baseline oxygenation (PaO2/FiO2; p < 0.001), more severe lymphopenia (p < 0.001) and higher LDH (p < 0.001), IL-6 (p = 0.021), C-reactive protein (CRP; p = 0.022) and procalcitonin (p = 0.002) serum levels. We defined "relevant viremia" when detection Ct was < 34 with Roche and < 31 for TFS. These thresholds had 95% sensitivity and 35% specificity. Relevant viremia predicted death during hospitalization (OR 9.2 [3.8–22.6] for Roche, OR 10.3 [3.6–29.3] for TFS; p < 0.001). Cox regression models, adjusted by age, sex and Charlson index, identified increased LDH serum levels and relevant viremia (HR = 9.87 [4.13–23.57] for TFS viremia and HR = 7.09 [3.3–14.82] for Roche viremia) as the best markers to predict mortality. Viremia assessment at admission is the most useful biomarker for predicting mortality in COVID-19 patients. Viremia is highly reproducible with two different techniques (TFS and Roche), has a good consistency with other severity biomarkers for COVID-19 and better predictive accuracy.https://doi.org/10.1038/s41598-021-92497-1 |