ArticleVirology journal2025
CfDNA as a surrogate marker for COVID-19 severity in patients with influenza-like symptoms with and without SARS-CoV-2 infection in general practice: a prospective cohort study.
Article in Virology journal, 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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Abstract
backgroundCell-free DNA (cfDNA) has emerged as a relevant biomarker reflecting disease severity in hospitalised COVID-19 patients, correlating with respiratory failure and mortality. However, its utility has not yet been evaluated in general practitioner setting.
methodsA prospective single-centre, two-arm, parallel, longitudinal cohort study conducted in a German general practice with four doctors between 8/2021 and 4/2022.
participantsSixty-one outpatients with flu-like symptoms participated: 31 (10 men, 21 women) tested SARS-CoV-2 positive (COVID group); 30 (12 men, 18 women) were controls (control group). The groups were demographically similar. PRIMARY OUTCOME MEASURES: Comparison of cfDNA levels between groups at day 0, 7 and 14. SECONDARY OUTCOME MEASURES: Correlations between cfDNA levels and laboratory and clinical parameters like blood counts, respiratory rate and oxygen saturation.
resultscfDNA levels did not differ significantly between groups (F [1, 59] = 1.538, p = 0.22): day 0: mean (± standard deviation) = 14.45 (± 6.24) ng/ml (COVID group) vs. 11.32 (± 4.79) ng/ml (control group); day 7: 14.46 (± 6.57) ng/ml vs. 12.53 (± 6.67) ng/ml; day 14: 12.94 (± 6.66) ng/ml vs. 12.93 (± 7.02) ng/ml. However, at t0, the integrity index was significantly lower in the COVID group (t0: 0.30 [±- 0.15] vs. 0.41 [± 0.1]; p = 0.0127) increasing at t1 (0.38 [± 0.17]; p = 0.008) and at t2 (0.42 [± 0.22]; p < 0.001).
conclusionUnlike hospitalised patients, cfDNA levels did not differ significantly between outpatient groups. Therefore, a decision on the need for hospitalisation based on clinical and serological factors is still required. The significantly lower integrity index of the SARS-CoV-2 infected individuals indicates that their DNA kinetics differ from those of individuals infected with other respiratory pathogens.
trial registrationGerman Clinical Trials Register: DRKS00024722, Registration date: 10 March 2021.
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