RT info:eu-repo/semantics/article
T1 Viral RNA load in plasma is associated with critical illness and a dysregulated host response in COVID-19
A1 Bermejo-Martin, Jesús F.
A1 González-Rivera, Milagros
A1 Almansa, Raquel
A1 Micheloud, Dariela
A1 Tedim, Ana P.
A1 Domínguez-Gil, Marta
A1 Resino, Salvador
A1 Martín-Fernández, Marta
A1 Ryan Murua, Pablo
A1 Pérez-García, Felipe
A1 Tamayo, Luis
A1 López Izquierdo, Raúl
A1 Bustamante, Elena
A1 Aldecoa, César
A1 Gómez, José Manuel
A1 Rico-Feijoo, Jesús
A1 Orduña, Antonio
A1 Méndez, Raúl
A1 Fernández Natal, Isabel
A1 Megías, Gregoria
A1 González-Estecha, Montserrat
A1 Carriedo, Demetrio
A1 Doncel, Cristina
A1 Jorge, Noelia
A1 Ortega, Alicia
A1 de la Fuente, Amanda
A1 del Campo, Félix
A1 Fernández-Ratero, José Antonio
A1 Trapiello, Wysali
A1 González-Jiménez, Paula
A1 Ruiz, Guadalupe
A1 Kelvin, Alyson A.
A1 Ostadgavahi, Ali Toloue
A1 Oneizat, Ruth
A1 Ruiz, Luz María
A1 Miguéns, Iria
A1 Gargallo, Esther
A1 Muñoz, Ioana
A1 Pelegrin, Sara
A1 Martín, Silvia
A1 García Olivares, Pablo
A1 Cedeño, Jamil Antonio
A1 Ruiz Albi, Tomás
A1 Puertas, Carolina
A1 Berezo, Jose Ángel
A1 Renedo, Gloria
A1 Herrán, Rubén
A1 Bustamante-Munguira, Juan
A1 Enríquez, Pedro
A1 Cicuendez, Ramón
A1 Blanco, Jesús
A1 Abadia, Jesica
A1 Gómez Barquero, Julia
A1 Mamolar, Nuria
A1 Blanca-López, Natalia
A1 Valdivia, Luis Jorge
A1 Fernández Caso, Belén
A1 Mantecón, María Ángeles
A1 Motos, Anna
A1 Fernandez-Barat, Laia
A1 Ferrer, Ricard
A1 Barbé, Ferrán
A1 Torres, Antoni
A1 Menéndez, Rosario
A1 Eiros Bouza, José María
A1 Kelvin, David J.
AB Background: COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response.Methods: A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients.Results: The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p < 0.001). Critical patients had higher viral RNA loads in plasma than non-critically ill patients, with non-survivors showing the highest values. When outpatients and ward patients were compared, viral RNAemia did not show significant associations in the multivariate analysis. In contrast, when ward patients were compared with ICU patients, both viral RNAemia and viral RNA load in plasma were associated with critical illness (OR [CI 95%], p): RNAemia (3.92 [1.183-12.968], 0.025), viral RNA load (N1) (1.962 [1.244-3.096], 0.004); viral RNA load (N2) (2.229 [1.382-3.595], 0.001). Viral RNA load in plasma correlated with higher levels of chemokines (CXCL10, CCL2), biomarkers indicative of a systemic inflammatory response (IL-6, CRP, ferritin), activation of NK cells (IL-15), endothelial dysfunction (VCAM-1, angiopoietin-2, ICAM-1), coagulation activation (D-Dimer and INR), tissue damage (LDH, GPT), neutrophil response (neutrophils counts, myeloperoxidase, GM-CSF) and immunodepression (PD-L1, IL-10, lymphopenia and monocytopenia).Conclusions: SARS-CoV-2 RNAemia and viral RNA load in plasma are associated with critical illness in COVID-19. Viral RNA load in plasma correlates with key signatures of dysregulated host responses, suggesting a major role of uncontrolled viral replication in the pathogenesis of this disease.
YR 2020
FD 2020
LK https://uvadoc.uva.es/handle/10324/65432
UL https://uvadoc.uva.es/handle/10324/65432
LA eng
NO Crit Care. 2020 Dec 14;24(1):691.
NO Producción Científica
DS UVaDOC
RD 11-jul-2024