RESUMEN
Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is generally detected in nasopharyngeal swabs, viral RNA can be found in other samples including blood. Recently, associations between SARS-CoV-2 RNAaemia and disease severity and mortality have been reported in adults, while no reports are available in pediatric patients with coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the mortality, severity, clinical, and laboratory findings of SARS-CoV-2 RNA detection in blood in 96 pediatric patients with confirmed COVID-19. Among all patients, 6 (6%) had SARS-CoV-2 RNAaemia. Out of the six patients with SARS-CoV-2 RNAaemia, four (67%) had a severe form of the disease, and two out of the 6 patients with SARS-CoV-2 RNAaemia passed away (33%). Our results show that the symptoms more commonly found in the cases of COVID-19 in the study (fever, cough, tachypnea, and vomiting), were found at a higher percentage in the patients with SARS-CoV-2 RNAaemia. Creatine phosphokinase and magnesium tests showed significant differences between the positive and negative SARS-CoV-2 RNAaemia groups. Among all laboratory tests, magnesium and creatine phosphokinase could better predict SARS-CoV-2 RNAemia with area under the curve levels of 0.808 and 0.748, respectively. In conclusion, 67% of individuals with SARS-CoV-2 RNAaemia showed a severe COVID-19 and one-third of the patients with SARS-CoV-2 RNAaemia passed away. Our findings suggest that magnesium and creatine phosphokinase might be considered as markers to estimate the SARS-CoV-2 RNAaemia.
Asunto(s)
COVID-19/patología , Creatina Quinasa/sangre , Magnesio/sangre , ARN Viral/sangre , SARS-CoV-2/patogenicidad , Viremia/patología , Adolescente , Biomarcadores/sangre , COVID-19/diagnóstico , COVID-19/mortalidad , COVID-19/virología , Prueba de Ácido Nucleico para COVID-19 , Niño , Preescolar , Tos/diagnóstico , Tos/mortalidad , Tos/patología , Tos/virología , Femenino , Fiebre/diagnóstico , Fiebre/mortalidad , Fiebre/patología , Fiebre/virología , Hospitales , Humanos , Lactante , Recién Nacido , Irán , Masculino , ARN Viral/genética , SARS-CoV-2/genética , Índice de Severidad de la Enfermedad , Análisis de Supervivencia , Taquipnea/diagnóstico , Taquipnea/mortalidad , Taquipnea/patología , Taquipnea/virología , Viremia/diagnóstico , Viremia/mortalidad , Viremia/virologíaRESUMEN
An 80-year-old man with multiple comorbidities presented to the emergency department with tachypnea, tachycardia, fever, and critically low O2 saturation and definitive chest computerized tomography scan findings in favor of COVID-19 and positive PCR results in 48 hours. He received antiviral treatment plus recombinant human erythropoietin (rhEPO) due to his severe anemia. After 7 days of treatment, he was discharged with miraculous improvement in his symptoms and hemoglobin level. We concluded that rhEPO could attenuate respiratory distress syndrome and confront the severe acute respiratory syndrome coronavirus 2 virus through multiple mechanisms including cytokine modulation, antiapoptotic effects, leukocyte release from bone marrow, and iron redistribution away from the intracellular virus.