On-admission SARS-CoV-2 RNAemia as a single potent predictive marker of critical condition development and mortality in COVID-19

被引:19
作者
Miki, Shoji [1 ]
Sasaki, Hiroaki [2 ]
Horiuchi, Hiroshi [2 ]
Miyata, Nobuyuki [2 ]
Yoshimura, Yukihiro [2 ]
Miyazaki, Kazuhito [3 ]
Matsumura, Takayuki [4 ]
Takahashi, Yoshimasa [4 ]
Suzuki, Tadaki [5 ]
Matano, Tetsuro [1 ,6 ,7 ]
Kawana-Tachikawa, Ai [1 ,6 ,7 ]
Tachikawa, Natsuo [2 ]
机构
[1] Natl Inst Infect Dis, AIDS Res Ctr, Tokyo, Japan
[2] Yokohama Municipal Citizens Hosp, Dept Infect Dis, Yokohama, Kanagawa, Japan
[3] Yokohama Municipal Citizens Hosp, Dept Resp Med, Yokohama, Kanagawa, Japan
[4] Natl Inst Infect Dis, Res Ctr Drug & Vaccine Dev, Tokyo, Japan
[5] Natl Inst Infect Dis, Dept Pathol, Tokyo, Japan
[6] Kumamoto Univ, Joint Res Ctr Human Retrovirus Infect, Kumamoto, Japan
[7] Univ Tokyo, Inst Med Sci, Dept Aids Vaccine Dev, Tokyo, Japan
关键词
COMMUNITY-ACQUIRED PNEUMONIA;
D O I
10.1371/journal.pone.0254640
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background This study aimed to clarify how SARS-CoV-2 RNAemia is related to COVID-19 critical condition development and mortality in comparison with other predictive markers and scoring systems. Methods This is a retrospective cohort study conducted at Yokohama Municipal Citizen's Hospital and National Institute of Infectious Diseases. We recruited adult patients with COVID-19 admitted between March 2020 and January 2021. We compared RNAemia with clinical status on admission including scoring systems such as the 4C Mortality, CURB-65, and A-DROP, as well as the C-t value of the nasopharyngeal PCR, in predicting COVID-19 mortality and critical condition development. Results Of the 92 recruited patients (median age, 58; interquartile range, 45-71 years), 14 (14.9%) had RNAemia. These patients had an older age (median, 68 years vs. 55.5 years; p = 0.011), higher values of lactated dehydrogenase (median, 381 U/L vs. 256.5 U/L, p < 0.001), C-reactive protein (median, 10.9 mg/dL vs. 3.8 mg/dL; p < 0.001), D-dimer (median, 2.07 mu g/mL vs. 1.28 mu g/mL; p = 0.015), lower values of lymphocyte (median, 802/mu L vs. 1007/mu L, p = 0.025) and C-t of the nasopharyngeal PCR assay (median, 20.59 vs. 25.54; p = 0.021) than those without RNAemia. Univariate analysis showed RNAemia was associated with mortality (odds ratio [OR], 18.75; 95% confidence interval [CI], 3.92-89.76; area under the receiver operating characteristic curve [AUC], 0.7851; p = 0.002) and critical condition (OR, 72.00; 95% CI, 12.98-399.29; AUC, 0.8198; p < 0.001). Plus, multivariate analysis also revealed the association of RNAemia with critical condition (adjusted OR, 125.71; 95% CI, 11.47-1377.32; p < 0.001). Conclusion On-admission SARS-CoV-2 RNAemia is a potent predictive marker of COVID-19 critical condition and mortality. The adjusted OR for critical condition was as high as 125.71.
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页数:11
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