SARS-CoV-2 RNA in plasma samples of COVID-19 affected individuals: a cross-sectional proof-of-concept study.
SARS-CoV-2 RNA in plasma samples of COVID-19 affected individuals: a cross-sectional proof-of-concept study.
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DOI：
10.1186/s12879-021-05886-2
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发表时间：
2021-02-17
影响因子：
3.7
通讯作者：
Perno CF
中科院分区：
文献类型：
--
作者：
Colagrossi L;Antonello M;Renica S;Merli M;Matarazzo E;Travi G;Vecchi M;Colombo J;Muscatello A;Grasselli G;Molteni SN;Scaravilli V;Cattaneo E;Fanti D;Vismara C;Bandera A;Gori A;Puoti M;Cento V;Alteri C;Perno CF
最近的研究表明，血浆SARS-CoV-2 RNA似乎与COVID-19预后恶化有关。然而，特定人群是否有更高的病毒血症风险，迄今尚未得到探索。这项横断面概念验证研究包括在米兰两家主要医院住院的41名sars - cov -2阳性成年人（6名患有血液系统恶性肿瘤），其中包括人口统计学、临床和实验室数据。配对血浆和呼吸道样本采用ddPCR定量检测SARS-CoV-2载量。为了评估病毒血症患者和非病毒血症患者之间的显著性差异，分类变量和连续变量分别采用Fisher精确检验和Wilcoxon检验。8例（19.5%）患者血浆中检测到SARS-CoV-2 RNA，中位（IQR）值为694（209-1023）拷贝/mL。与没有病毒血症的患者相比，病毒血症患者的死亡率更高（50.0% vs 9.1%; p = 0.018）。病毒血症患者更容易受到血液系统恶性肿瘤的影响（62.5%对3.0%,p < 0.001），并且呼吸样本中的病毒载量更高（9,404,000[586,060-10,000,000]对1560[312-25,160]拷贝/mL， p = 0.002）。即使基于小样本人群，这项概念验证性研究也为早期识别具有较高SARS-CoV-2病毒血症风险（因此可能发展为严重的COVID-19）的患者奠定了基础，并支持在COVID-19血液病患者的血液和呼吸样本中定量测定病毒载量的必要性，以便预测预后，从而帮助其进一步管理。在线版本包含补充材料，可在10.1186/s12879- 021-058886 -2获得。
Recent studies showed that plasma SARS-CoV-2 RNA seems to be associated with worse COVID-19 outcome. However, whether specific population can be at higher risk of viremia are to date unexplored. This cross-sectional proof-of-concept study included 41 SARS-CoV-2-positive adult individuals (six affected by haematological malignancies) hospitalized at two major hospital in Milan, for those demographic, clinical and laboratory data were available. SARS-CoV-2 load was quantified by ddPCR in paired plasma and respiratory samples. To assess significant differences between patients with and patients without viremia, Fisher exact test and Wilcoxon test were used for categorical and continuous variables, respectively. Plasma SARS-CoV-2 RNA was found in 8 patients (19.5%), with a median (IQR) value of 694 (209–1023) copies/mL. Viremic patients were characterized by an higher mortality rate (50.0% vs 9.1%; p = 0.018) respect to patients without viremia. Viremic patients were more frequently affected by haematological malignancies (62.5% vs. 3.0%; p < 0.001), and had higher viral load in respiratory samples (9,404,000 [586,060-10,000,000] vs 1560 [312–25,160] copies/mL; p = 0.002). Even if based on a small sample population, this proof-of-concept study poses the basis for an early identification of patients at higher risk of SARS-CoV-2 viremia, and therefore likely to develop severe COVID-19, and supports the need of a quantitative viral load determination in blood and respiratory samples of haematologic patients with COVID-19 in order to predict prognosis and consequently to help their further management. The online version contains supplementary material available at 10.1186/s12879-021-05886-2.
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