Luna Colagrossi1, Maria Antonello2, Silvia Renica2, Marco Merli3, Elisa Matarazzo4, Giovanna Travi3, Marta Vecchi3, Jacopo Colombo5, Antonio Muscatello6,7, Giacomo Grasselli8, Silvia Nerini Molteni9, Vittorio Scaravilli8, Emanuele Cattaneo8, Diana Fanti9, Chiara Vismara9, Alessandra Bandera6,7, Andrea Gori6,7, Massimo Puoti3, Valeria Cento2, Claudia Alteri10, Carlo Federico Perno1. 1. Department of Laboratories, Unit of Diagnostic Microbiology and Immunology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. 2. Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milan, Italy. 3. Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. 4. Residency in Microbiology and Virology, Università degli Studi di Milano, Milan, Italy. 5. Department of Cardiotoracovascular Anesthesia and Intensive Care, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. 6. Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, Italy. 7. Infectious Diseases Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Milan, Italy. 8. Department of Anaesthesia and Critical Care, IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Milan, Italy. 9. Chemical-clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. 10. Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milan, Italy. claudia.alteri@unimi.it.
Abstract
BACKGROUND: Recent studies showed that plasma SARS-CoV-2 RNA seems to be associated with worse COVID-19 outcome. However, whether specific population can be at higher risk of viremia are to date unexplored. METHODS: This cross-sectional proof-of-concept study included 41 SARS-CoV-2-positive adult individuals (six affected by haematological malignancies) hospitalized at two major hospital in Milan, for those demographic, clinical and laboratory data were available. SARS-CoV-2 load was quantified by ddPCR in paired plasma and respiratory samples. To assess significant differences between patients with and patients without viremia, Fisher exact test and Wilcoxon test were used for categorical and continuous variables, respectively. RESULTS: Plasma SARS-CoV-2 RNA was found in 8 patients (19.5%), with a median (IQR) value of 694 (209-1023) copies/mL. Viremic patients were characterized by an higher mortality rate (50.0% vs 9.1%; p = 0.018) respect to patients without viremia. Viremic patients were more frequently affected by haematological malignancies (62.5% vs. 3.0%; p < 0.001), and had higher viral load in respiratory samples (9,404,000 [586,060-10,000,000] vs 1560 [312-25,160] copies/mL; p = 0.002). CONCLUSIONS: Even if based on a small sample population, this proof-of-concept study poses the basis for an early identification of patients at higher risk of SARS-CoV-2 viremia, and therefore likely to develop severe COVID-19, and supports the need of a quantitative viral load determination in blood and respiratory samples of haematologic patients with COVID-19 in order to predict prognosis and consequently to help their further management.
BACKGROUND: Recent studies showed that plasma SARS-CoV-2 RNA seems to be associated with worse COVID-19 outcome. However, whether specific population can be at higher risk of viremia are to date unexplored. METHODS: This cross-sectional proof-of-concept study included 41 SARS-CoV-2-positive adult individuals (six affected by haematological malignancies) hospitalized at two major hospital in Milan, for those demographic, clinical and laboratory data were available. SARS-CoV-2 load was quantified by ddPCR in paired plasma and respiratory samples. To assess significant differences between patients with and patients without viremia, Fisher exact test and Wilcoxon test were used for categorical and continuous variables, respectively. RESULTS: Plasma SARS-CoV-2 RNA was found in 8 patients (19.5%), with a median (IQR) value of 694 (209-1023) copies/mL. Viremic patients were characterized by an higher mortality rate (50.0% vs 9.1%; p = 0.018) respect to patients without viremia. Viremic patients were more frequently affected by haematological malignancies (62.5% vs. 3.0%; p < 0.001), and had higher viral load in respiratory samples (9,404,000 [586,060-10,000,000] vs 1560 [312-25,160] copies/mL; p = 0.002). CONCLUSIONS: Even if based on a small sample population, this proof-of-concept study poses the basis for an early identification of patients at higher risk of SARS-CoV-2 viremia, and therefore likely to develop severe COVID-19, and supports the need of a quantitative viral load determination in blood and respiratory samples of haematologic patients with COVID-19 in order to predict prognosis and consequently to help their further management.
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