Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study.
Aged
Antibodies, Neutralizing
/ blood
Antibodies, Viral
/ blood
COVID-19
/ complications
COVID-19 Serological Testing
/ methods
Enzyme-Linked Immunosorbent Assay
Female
Germany
/ epidemiology
Humans
Immunoglobulin A
/ blood
Immunoglobulin G
/ blood
Immunoglobulin M
/ blood
Male
Middle Aged
Protein Domains
/ immunology
RNA, Viral
/ genetics
Respiratory Distress Syndrome
/ etiology
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
SARS-CoV-2
/ genetics
Spike Glycoprotein, Coronavirus
/ immunology
Viral Load
/ genetics
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
09
2020
accepted:
12
11
2020
entrez:
24
11
2020
pubmed:
25
11
2020
medline:
15
12
2020
Statut:
epublish
Résumé
The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay. Most patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009). COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.
Sections du résumé
BACKGROUND
The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS).
METHODS
This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay.
RESULTS
Most patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009).
CONCLUSIONS
COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.
Identifiants
pubmed: 33232382
doi: 10.1371/journal.pone.0242917
pii: PONE-D-20-27460
pmc: PMC7685466
doi:
Substances chimiques
Antibodies, Neutralizing
0
Antibodies, Viral
0
Immunoglobulin A
0
Immunoglobulin G
0
Immunoglobulin M
0
RNA, Viral
0
Spike Glycoprotein, Coronavirus
0
spike protein, SARS-CoV-2
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0242917Déclaration de conflit d'intérêts
T. Schlesinger, B. Weißbrich, F. Wedekink, Q. Notz, J. Herrmann, M. Krone, M. Sitter, B. Schmid, L. Dölken, P. Kranke, C. Lotz have nothing to disclose. M. Kredel reports personal fees from Pfizer, outside the submitted work. J. Wischhusen reports personal fees from CatalYm GmbH, outside the submitted work. P. Meybohm reports grants from B. Braun Melsungen, grants from CSL Behring, grants from Fresenius Kabi, grants from Vifor Pharma, outside the submitted work. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
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