Severe Acute Respiratory Syndrome Coronavirus 2 RNA in Serum as Predictor of Severe Outcome in Coronavirus Disease 2019: A Retrospective Cohort Study
Severe Acute Respiratory Syndrome Coronavirus 2 RNA in Serum as Predictor of Severe Outcome in Coronavirus Disease 2019: A Retrospective Cohort Study
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DOI：
10.1093/cid/ciaa1285
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发表时间：
2021-11-01
影响因子：
11.8
通讯作者：
Ursing, Johan
中科院分区：
文献类型：
--
作者：
Hagman, Karl;Hedenstierna, Magnus;Ursing, Johan
背景资料。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)导致2019年冠状病毒病(新冠肺炎)。本研究旨在确定入院时血清SARS-CoV-2RNA是否与COVID-19患者的临床转归相关。纳入2020年4月10日至6月30日在瑞典一家三级医院感染科住院并于入院时抽取血清检测SARS-CoV-2RNA的新冠肺炎患者。主要结果是第28天全因死亡率和危重疾病进展。队列(N=167)包括106例血清SARS-CoV-2RNA阴性患者和61例血清阳性患者。首次SARS-CoV-2的中位采样时间为入院后第1天(四分位数范围[IQR]，1-2天)，相当于症状出现后第10天(IQR，8-12天)。血清阴性和阳性患者的平均年龄分别为53岁(IQR，44-67岁)和63岁(IQR，52-74岁)。血清阴性组106例，死亡3例；血清阳性组61例，死亡15例。与血清阴性患者相比，血清阳性患者的危重疾病风险比和全因死亡率风险比分别为7.2(95%可信区间，3.0~17)和8.6(95%可信区间，2.4~30)。入院时血清中的SARS-CoV-2RNA表明发展为危重疾病和死亡的风险很高。
Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19). This study aimed to determine if SARS-CoV-2 RNA in serum at admission correlated with clinical outcome in COVID-19.Methods. COVID-19 patients admitted to the infectious diseases department of a tertiary level Swedish hospital and sampled for SARS-CoV-2 RNA in serum at admission during 10 April to 30 June 2020 were included. Primary outcomes were day 28 all-cause mortality and progress to critical disease.Results. The cohort (N = 167) consisted of 106 SARS-CoV-2 RNA serum-negative and 61 serum-positive patients. Median sampling time for initial SARS-CoV-2 in serum was 1 day (interquartile range [IQR], 1-2 days) after admission, corresponding to day 10 (IQR, 8-12) after symptom onset. Median age was 53 years (IQR, 44-67 years) and 63 years (IQR, 52-74 years) for the serum-negative and -positive patients, respectively. In the serum-negative and -positive groups, 3 of 106 and 15 of 61 patients died, respectively. The hazard ratios for critical disease and all-cause mortality were 7.2 (95% confidence interval [CI], 3.0-17) and 8.6 (95% CI, 2.4-30), respectively, for patients with serum-positive compared to serum-negative results.Conclusions. SARS-CoV-2 RNA in serum at hospital admission indicates a high risk of progression to critical disease and death.