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SARS-CoV-2 viremia and COVID-19 mortality: A prospective observational study.
Giacomelli, Andrea; Righini, Elena; Micheli, Valeria; Pinoli, Pietro; Bernasconi, Anna; Rizzo, Alberto; Oreni, Letizia; Ridolfo, Anna Lisa; Antinori, Spinello; Ceri, Stefano; Rizzardini, Giuliano.
  • Giacomelli A; Dipartimento di Malattie Infettive, ASST-FBF-Sacco, Milano, Italia.
  • Righini E; Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, Milano, Italia.
  • Micheli V; Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST-FBF-Sacco, Milan, Italy.
  • Pinoli P; Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, Milano, Italia.
  • Bernasconi A; Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, Milano, Italia.
  • Rizzo A; Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST-FBF-Sacco, Milan, Italy.
  • Oreni L; Dipartimento di Malattie Infettive, ASST-FBF-Sacco, Milano, Italia.
  • Ridolfo AL; Dipartimento di Malattie Infettive, ASST-FBF-Sacco, Milano, Italia.
  • Antinori S; Dipartimento di Malattie Infettive, ASST-FBF-Sacco, Milano, Italia.
  • Ceri S; Dipartimento di Scienze Biomediche e Cliniche Luigi Sacco, Università degli Studi di Milano, Milano, Italia.
  • Rizzardini G; Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, Milano, Italia.
PLoS One ; 18(4): e0281052, 2023.
Article in English | MEDLINE | ID: covidwho-2295531
ABSTRACT

BACKGROUND:

SARS-CoV-2 viremia has been found to be a potential prognostic factor in patients hospitalized for COVID-19.

OBJECTIVE:

We aimed to assess the association between SARS-CoV-2 viremia and mortality in COVID-19 hospitalized patients during different epidemic periods.

METHODS:

A prospective COVID-19 registry was queried to extract all COVID-19 patients with an available SARS-CoV-2 viremia performed at hospital admission between March 2020 and January 2022. SARS-CoV-2 viremia was assessed by means of GeneFinderTM COVID-19 Plus RealAmp Kit assay and SARS-CoV-2 ELITe MGB® Kit using <45 cycle threshold to define positivity. Uni and multivariable logistic regression model were built to assess the association between SARS-CoV-2 positive viremia and death.

RESULTS:

Four hundred and forty-five out of 2,822 COVID-19 patients had an available SARS-CoV-2 viremia, prevalently males (64.9%) with a median age of 65 years (IQR 55-75). Patients with a positive SARS-CoV-2 viremia (86/445; 19.3%) more frequently presented with a severe or critical disease (67.4% vs 57.1%) when compared to those with a negative SARS-CoV-2 viremia. Deceased subjects (88/445; 19.8%) were older [75 (IQR 68-82) vs 63 (IQR 54-72)] and showed more frequently a detectable SARS-CoV-2 viremia at admission (60.2% vs 22.7%) when compared to survivors. In univariable analysis a positive SARS-CoV-2 viremia was associated with a higher odd of death [OR 5.16 (95% CI 3.15-8.45)] which was confirmed in the multivariable analysis adjusted for age, biological sex and, disease severity [AOR 6.48 (95% CI 4.05-10.45)]. The association between positive SARS-CoV-2 viremia and death was consistent in the period 1 February 2021-31 January 2022 [AOR 5.86 (95% CI 3.43-10.16)] and in subgroup analysis according to disease severity mild/moderate [AOR 6.45 (95% CI 2.84-15.17)] and severe/critical COVID-19 patients [AOR 6.98 (95% CI 3.68-13.66)].

CONCLUSIONS:

SARS-CoV-2 viremia resulted associated to COVID-19 mortality and should be considered in the initial assessment of COVID-19 hospitalized patients.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2023 Document Type: Article Affiliation country: Journal.pone.0281052

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2023 Document Type: Article Affiliation country: Journal.pone.0281052