ArticlePloS one2025
Factors associated with SARS-CoV-2 RNAemia development at COVID-19 diagnosis.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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30 authors.
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Abstract
objectivesSARS-CoV-2 RNAemia at diagnosis is associated with mortality. The aims were to identify factors associated with the development of RNAemia.
methodsMulticenter COVID-19 cohort study was conducted between January 2020 and May 2023. Demographics, chronic underlying diseases, symptoms and signs, analytical and radiological variables, cytokines, and neutralizing antibodies were evaluated on admission. RNAemia was the primary endpoint.
resultsWe included 1011 patients, 392 (38.8%) immunocompromised and 619 (61.2%) immunocompetent. RNAemia occurred in 49.7% and 18.7% (p < 0.001), respectively, being independently associated with 30-day all-cause mortality. In immunocompromised patients, factors independently associated with RNAemia were Alpha and Omicron VOC periods (OR: 1.95 [1.01-3.79]), pneumonia (OR: 1.96 [1.10-3.50]), LDH > 300 UI/L (OR: 1.64 [1.02-2.63]) and neutralizing antibodies absence (OR: 2.51 [1.57-4.00]). In immunocompetent patients, the factors associated with RNAemia were Delta and Omicron VOC periods (OR: 2.27 [1.46-3.52]), lymphocyte count < 1000/µL (OR: 1.81 [1.16-2.80]) and LDH levels > 300 IU/L (OR: 3.99 [2.51-6.36]).
conclusionsImmunodeficiency almost tripled SARS-CoV-2 RNAemia. Omicron VOC period, LDH as inflammatory biomarker, and a lower immune response in all patients, neutralizing antibodies absence in immunocompromised and lymphopenia in immunocompetent, and pneumonia in immunocompromised patients were associated with RNAemia.
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