PLoS ONE (Jan 2021)

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

  • Shoji Miki,
  • Hiroaki Sasaki,
  • Hiroshi Horiuchi,
  • Nobuyuki Miyata,
  • Yukihiro Yoshimura,
  • Kazuhito Miyazaki,
  • Takayuki Matsumura,
  • Yoshimasa Takahashi,
  • Tadaki Suzuki,
  • Tetsuro Matano,
  • Ai Kawana-Tachikawa,
  • Natsuo Tachikawa

DOI
https://doi.org/10.1371/journal.pone.0254640
Journal volume & issue
Vol. 16, no. 7
p. e0254640

Abstract

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BackgroundThis 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.MethodsThis 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 Ct value of the nasopharyngeal PCR, in predicting COVID-19 mortality and critical condition development.ResultsOf 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 ConclusionOn-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.