PLoS ONE (Jan 2020)

Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study.

  • Tobias Schlesinger,
  • Benedikt Weißbrich,
  • Florian Wedekink,
  • Quirin Notz,
  • Johannes Herrmann,
  • Manuel Krone,
  • Magdalena Sitter,
  • Benedikt Schmid,
  • Markus Kredel,
  • Jan Stumpner,
  • Lars Dölken,
  • Jörg Wischhusen,
  • Peter Kranke,
  • Patrick Meybohm,
  • Christopher Lotz

DOI
https://doi.org/10.1371/journal.pone.0242917
Journal volume & issue
Vol. 15, no. 11
p. e0242917

Abstract

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BackgroundThe viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS).MethodsThis is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay.ResultsMost patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009).ConclusionsCOVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.