Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 4 de 4
Filter
1.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-294072

ABSTRACT

Background: Severe COVID-19 has been proposed to represent a form of viral sepsis. The prevalence of sepsis due to this disease has not been evaluated. Some patients with severe COVID-19 present SARS-CoV-2 antigenemia. Whether antigenemia constitutes a factor associated to viral sepsis and fatal outcome in these patients is unknown. Methods: This study recruited 400 patients hospitalized with COVID-19. Prevalence of sepsis in the first 24 hours following hospitalization was determined using the SEPSIS-3 criteria. Prevalence and concentration of SARS-CoV-2 N-antigenemia was determined in plasma at hospitalization using the Panbio® COVID-19 Ag Rapid Test from Abbott and the COV-QUANTO® ELISA from AAZ. Findings: The prevalence of sepsis due to SARS-CoV-2 infection at hospitalization was of 54%, affecting mostly to the respiratory, renal and coagulation function. Antigenemia was present in the 53% of the patients, and constituted an independent risk factor of sepsis in the multivariate analysis (OR [CI95%], p): presence of N-antigenemia (Panbio®): (1·6 [1·1 - 2·5],0·023);concentration of N-antigen >575 pg/mL (COV-QUANTO®): (1·9 [1·0 - 3·5], 0·043). Antigenemia was associated with a reduction in the survival mean time of 9·42 and 9·33 days in the 90 first days following hospitalization, based on the PANBIO® and the COV-QUANTO® tests respectively. Interpretation: Half of the COVID-19 patients needing of hospitalization fulfill the criteria of sepsis. Antigenemia is strongly linked to the presence of this condition, and confers a higher risk of mortality. Monitoring the presence of antigenemia at the earlier moments of COVID-19 could help to identify those patients at risk of deterioration. Clinical Trial Registration Details: This was a sub-study of the CIBERES-UCI-COVID project, registered at Clinicaltrials.gov with the identification NCT04457505. Funding Information: Instituto de Salud Carlos III (COV20/00110;CP20/00041;FI20/00278), Fundació La Marató de TV3 (473/C/2021).Declaration of Interests: AT, JME, FB, RA and JFBM have a patent application on SARS-CoV-2 antigenemia. The remainder authors declare no conflicts of interest regarding this work.Ethics Approval Statement: Written or oral informed consent was obtained directly from all patients, or their legal representative, before enrolment. Scientific and ethical approval of the study protocol was obtained from the respective scientific committees for clinical research of the participant hospitals.

2.
J Intern Med ; 291(2): 232-240, 2022 02.
Article in English | MEDLINE | ID: covidwho-1455598

ABSTRACT

BACKGROUND: Anti-SARS-CoV-2 S antibodies prevent viral replication. Critically ill COVID-19 patients show viral material in plasma, associated with a dysregulated host response. If these antibodies influence survival and viral dissemination in ICU-COVID patients is unknown. PATIENTS/METHODS: We studied the impact of anti-SARS-CoV-2 S antibodies levels on survival, viral RNA-load in plasma, and N-antigenaemia in 92 COVID-19 patients over ICU admission. RESULTS: Frequency of N-antigenaemia was >2.5-fold higher in absence of antibodies. Antibodies correlated inversely with viral RNA-load in plasma, representing a protective factor against mortality (adjusted HR [CI 95%], p): (S IgM [AUC ≥ 60]: 0.44 [0.22; 0.88], 0.020); (S IgG [AUC ≥ 237]: 0.31 [0.16; 0.61], <0.001). Viral RNA-load in plasma and N-antigenaemia predicted increased mortality: (N1-viral load [≥2.156 copies/ml]: 2.25 [1.16; 4.36], 0.016); (N-antigenaemia: 2.45 [1.27; 4.69], 0.007). CONCLUSIONS: Low anti-SARS-CoV-2 S antibody levels predict mortality in critical COVID-19. Our findings support that these antibodies contribute to prevent systemic dissemination of SARS-CoV-2.


Subject(s)
Antibodies, Viral/blood , Antigens, Viral/blood , COVID-19 , COVID-19/immunology , COVID-19/mortality , Critical Illness , Humans , RNA, Viral/blood , SARS-CoV-2
3.
Transl Res ; 236: 147-159, 2021 10.
Article in English | MEDLINE | ID: covidwho-1243239

ABSTRACT

We aimed to examine the circulating microRNA (miRNA) profile of hospitalized COVID-19 patients and evaluate its potential as a source of biomarkers for the management of the disease. This was an observational and multicenter study that included 84 patients with a positive nasopharyngeal swab Polymerase chain reaction (PCR) test for SARS-CoV-2 recruited during the first pandemic wave in Spain (March-June 2020). Patients were stratified according to disease severity: hospitalized patients admitted to the clinical wards without requiring critical care and patients admitted to the intensive care unit (ICU). An additional study was completed including ICU nonsurvivors and survivors. Plasma miRNA profiling was performed using reverse transcription polymerase quantitative chain reaction (RT-qPCR). Predictive models were constructed using least absolute shrinkage and selection operator (LASSO) regression. Ten circulating miRNAs were dysregulated in ICU patients compared to ward patients. LASSO analysis identified a signature of three miRNAs (miR-148a-3p, miR-451a and miR-486-5p) that distinguishes between ICU and ward patients [AUC (95% CI) = 0.89 (0.81-0.97)]. Among critically ill patients, six miRNAs were downregulated between nonsurvivors and survivors. A signature based on two miRNAs (miR-192-5p and miR-323a-3p) differentiated ICU nonsurvivors from survivors [AUC (95% CI) = 0.80 (0.64-0.96)]. The discriminatory potential of the signature was higher than that observed for laboratory parameters such as leukocyte counts, C-reactive protein (CRP) or D-dimer [maximum AUC (95% CI) for these variables = 0.73 (0.55-0.92)]. miRNA levels were correlated with the duration of ICU stay. Specific circulating miRNA profiles are associated with the severity of COVID-19. Plasma miRNA signatures emerge as a novel tool to assist in the early prediction of vital status deterioration among ICU patients.


Subject(s)
COVID-19/blood , COVID-19/genetics , Circulating MicroRNA/blood , Hospitalization , Severity of Illness Index , Aged , Biomarkers/blood , COVID-19/virology , Critical Illness , Female , Humans , Intensive Care Units , Male , SARS-CoV-2/physiology
4.
Crit Care ; 24(1): 691, 2020 12 14.
Article in English | MEDLINE | ID: covidwho-977684

ABSTRACT

BACKGROUND: COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response. METHODS: A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients. RESULTS: The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p < 0.001). Critical patients had higher viral RNA loads in plasma than non-critically ill patients, with non-survivors showing the highest values. When outpatients and ward patients were compared, viral RNAemia did not show significant associations in the multivariate analysis. In contrast, when ward patients were compared with ICU patients, both viral RNAemia and viral RNA load in plasma were associated with critical illness (OR [CI 95%], p): RNAemia (3.92 [1.183-12.968], 0.025), viral RNA load (N1) (1.962 [1.244-3.096], 0.004); viral RNA load (N2) (2.229 [1.382-3.595], 0.001). Viral RNA load in plasma correlated with higher levels of chemokines (CXCL10, CCL2), biomarkers indicative of a systemic inflammatory response (IL-6, CRP, ferritin), activation of NK cells (IL-15), endothelial dysfunction (VCAM-1, angiopoietin-2, ICAM-1), coagulation activation (D-Dimer and INR), tissue damage (LDH, GPT), neutrophil response (neutrophils counts, myeloperoxidase, GM-CSF) and immunodepression (PD-L1, IL-10, lymphopenia and monocytopenia). CONCLUSIONS: SARS-CoV-2 RNAemia and viral RNA load in plasma are associated with critical illness in COVID-19. Viral RNA load in plasma correlates with key signatures of dysregulated host responses, suggesting a major role of uncontrolled viral replication in the pathogenesis of this disease.


Subject(s)
COVID-19/complications , RNA, Viral/analysis , Viral Load/immunology , Adult , Aged , Biomarkers/analysis , Biomarkers/blood , COVID-19/blood , Chi-Square Distribution , Critical Illness , Female , Humans , Male , Middle Aged , Multivariate Analysis , Polymerase Chain Reaction/methods , RNA, Viral/blood , Statistics, Nonparametric
SELECTION OF CITATIONS
SEARCH DETAIL