Association of high SARS-CoV-2 RNAemia with diabetes and mortality in critically ill COVID-19 patients
Mehran Monchi,
Thomas Bruneau,
Sebastien Jochmans,
David Veyer,
Aurelia Pitsch,
Olivier Ellrodt,
Marie Picque,
Valérie Taly,
Oumar Sy,
Sandie Mazerand,
Sylvain Diamantis,
Hélène Péré
Affiliations
Mehran Monchi
Service de médecine intensive - réanimation, centre hospitalier de Melun-Senart, 270 avenue Marc Jacquet, 77000 Melun, France; Corresponding author
Thomas Bruneau
Service de Microbiologie (Unité de virologie), Hôpital Européen Georges Pompidou, 75015 Paris, France
Sebastien Jochmans
Service de médecine intensive - réanimation, centre hospitalier de Melun-Senart, 270 avenue Marc Jacquet, 77000 Melun, France
David Veyer
Service de Microbiologie (Unité de virologie), Hôpital Européen Georges Pompidou, 75015 Paris, France
Aurelia Pitsch
Service de Microbiologie, centre hospitalier de Melun-Senart, 77000 Melun, France
Olivier Ellrodt
Service de médecine intensive - réanimation, centre hospitalier de Melun-Senart, 270 avenue Marc Jacquet, 77000 Melun, France
Marie Picque
Service de Microbiologie, centre hospitalier de Melun-Senart, 77000 Melun, France
Valérie Taly
Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, UMRS 1138, Equipe MEPPOT, 15 Rue de L'école de Médecine, 75006 Paris, France
Oumar Sy
Service de médecine intensive - réanimation, centre hospitalier de Melun-Senart, 270 avenue Marc Jacquet, 77000 Melun, France
Sandie Mazerand
Service de médecine intensive - réanimation, centre hospitalier de Melun-Senart, 270 avenue Marc Jacquet, 77000 Melun, France
Sylvain Diamantis
Service de maladies infectieuses et tropicales, centre hospitalier de Melun-Senart, and DYNAMIC research Unit, Université Paris-Est-Creteil, 77000 Melun France
Hélène Péré
Service de Microbiologie (Unité de virologie), Hôpital Européen Georges Pompidou, 75015 Paris, France; Corresponding author
Summary: It has been suggested that during the period of respiratory worsening of severe COVID-19 patients, viral replication plays a less important role than inflammation. Using the droplet-based digital PCR (ddPCR) for precise quantification of plasma SARS-CoV-2 viral load (SARS-CoV-2 RNAemia), we investigated the relationship between plasma viral load, comorbidities, and mortality of 122 critically ill COVID-19 patients. SARS-CoV-2 RNAemia was detected by ddPCR in 90 (74%) patients, ranging from 70 to 213,152 copies per mL. A high (>1 000 copies/ml) or very high (>10,000 copies/ml) SARS-Cov-2 RNAemia was observed in 46 patients (38%), of which 26 were diabetic. Diabetes was independently associated with a higher SARS-CoV-2 RNAemia. In multivariable logistic regression models, SARS-CoV-2 RNAemia was strongly and independently associated with day-60 mortality. Early initiation of antiviral therapies might be considered in COVID-19 critically ill patients with high RNAemia.
