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Article

RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients

1
Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
2
Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
3
Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
4
German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, 50937 Cologne, Germany
5
Center for Molecular Medicine Cologne, University of Cologne, 50937 Cologne, Germany
6
Center of Integrated Oncology ABCD, University Hospital of Cologne, 50937 Cologne, Germany
7
Intensive Care Program, Department I of Internal Medicine, University Hospital of Cologne, 50937 Cologne, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Received: 13 August 2020 / Revised: 12 September 2020 / Accepted: 15 September 2020 / Published: 18 September 2020
(This article belongs to the Collection Coronaviruses)
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global health emergency. To improve the understanding of the systemic component of SARS-CoV-2, we investigated if viral load dynamics in plasma and respiratory samples are associated with antibody response and severity of coronavirus disease 2019 (COVID-19). SARS-CoV-2 RNA was found in plasma samples from 14 (44%) out of 32 patients. RNAemia was detected in 5 out of 6 fatal cases. Peak IgG values were significantly lower in mild/moderate than in severe (0.6 (interquartile range, IQR, 0.4–3.2) vs. 11.8 (IQR, 9.9–13.0), adjusted p = 0.003) or critical cases (11.29 (IQR, 8.3–12.0), adjusted p = 0.042). IgG titers were significantly associated with virus Ct (Cycle threshold) value in plasma and respiratory specimens ((ß = 0.4, 95% CI (confidence interval, 0.2; 0.5), p < 0.001 and ß = 0.5, 95% CI (0.2; 0.6), p = 0.002). A classification as severe or a critical case was additionally inversely associated with Ct values in plasma in comparison to mild/moderate cases (ß = −3.3, 95% CI (−5.8; 0.8), p = 0.024 and ß = −4.4, 95% CI (−7.2; 1.6), p = 0.007, respectively). Based on the present data, our hypothesis is that the early stage of SARS-CoV-2 infection is characterized by a primary RNAemia, as a potential manifestation of a systemic infection. Additionally, the viral load in plasma seems to be associated with a worse disease outcome. View Full-Text
Keywords: SARS-CoV-2; humoral response; seroconversion; dynamics; viral load; blood; viremia; antibodies SARS-CoV-2; humoral response; seroconversion; dynamics; viral load; blood; viremia; antibodies
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MDPI and ACS Style

Eberhardt, K.A.; Meyer-Schwickerath, C.; Heger, E.; Knops, E.; Lehmann, C.; Rybniker, J.; Schommers, P.; Eichenauer, D.A.; Kurth, F.; Ramharter, M.; Kaiser, R.; Holtick, U.; Klein, F.; Jung, N.; Di Cristanziano, V. RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients. Viruses 2020, 12, 1045. https://0-doi-org.brum.beds.ac.uk/10.3390/v12091045

AMA Style

Eberhardt KA, Meyer-Schwickerath C, Heger E, Knops E, Lehmann C, Rybniker J, Schommers P, Eichenauer DA, Kurth F, Ramharter M, Kaiser R, Holtick U, Klein F, Jung N, Di Cristanziano V. RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients. Viruses. 2020; 12(9):1045. https://0-doi-org.brum.beds.ac.uk/10.3390/v12091045

Chicago/Turabian Style

Eberhardt, Kirsten A.; Meyer-Schwickerath, Charlotte; Heger, Eva; Knops, Elena; Lehmann, Clara; Rybniker, Jan; Schommers, Philipp; Eichenauer, Dennis A.; Kurth, Florian; Ramharter, Michael; Kaiser, Rolf; Holtick, Udo; Klein, Florian; Jung, Norma; Di Cristanziano, Veronica. 2020. "RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients" Viruses 12, no. 9: 1045. https://0-doi-org.brum.beds.ac.uk/10.3390/v12091045

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