In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 7 ( 2021-7-13), p. e0254640-
Abstract:
This 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. Methods This 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 C t value of the nasopharyngeal PCR, in predicting COVID-19 mortality and critical condition development. Results Of 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 〈 0.001), C-reactive protein (median, 10.9 mg/dL vs. 3.8 mg/dL; p 〈 0.001), D-dimer (median, 2.07 μg/mL vs. 1.28 μg/mL; p = 0.015), lower values of lymphocyte (median, 802/μL vs. 1007/μL, p = 0.025) and C t of the nasopharyngeal PCR assay (median, 20.59 vs. 25.54; p = 0.021) than those without RNAemia. Univariate analysis showed RNAemia was associated with mortality (odds ratio [OR], 18.75; 95% confidence interval [CI] , 3.92–89.76; area under the receiver operating characteristic curve [AUC], 0.7851; p = 0.002) and critical condition (OR, 72.00; 95% CI, 12.98–399.29; AUC, 0.8198; p 〈 0.001). Plus, multivariate analysis also revealed the association of RNAemia with critical condition (adjusted OR, 125.71; 95% CI, 11.47–1377.32; p 〈 0.001). Conclusion On-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.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0254640
DOI:
10.1371/journal.pone.0254640.g001
DOI:
10.1371/journal.pone.0254640.g002
DOI:
10.1371/journal.pone.0254640.g003
DOI:
10.1371/journal.pone.0254640.t001
DOI:
10.1371/journal.pone.0254640.t002
DOI:
10.1371/journal.pone.0254640.t003
DOI:
10.1371/journal.pone.0254640.s001
DOI:
10.1371/journal.pone.0254640.s002
DOI:
10.1371/journal.pone.0254640.r001
DOI:
10.1371/journal.pone.0254640.r002
DOI:
10.1371/journal.pone.0254640.r003
DOI:
10.1371/journal.pone.0254640.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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