NEW YORK (Reuters Health) – The amount of viral RNA in blood can reliably identity patients who are at higher risk of dying from COVID-19, a new study suggests.
“There is no need to perform multiple, complicated measurements to have a very good indicator and identify patients at high mortality risk,” Dr. Daniel E. Kaufmann of CHUM Research Center and the University of Montreal, in Canada, told Reuters Health by email.
While management of COVID-19 has improved, it remains challenging to predict which patients will die from the disease, he and his colleagues note in a paper in Science Advances.
To identify early predictors of death, they performed immunovirological assessments on blood samples obtained from 279 patients hospitalized with moderate to severe COVID-19.
Viral RNA, with predefined adjustment for age and sex, “robustly identified patients with fatal outcome (adjusted hazard ratio for log-transformed vRNA, 3.5), the researchers report.
“Among all of the biomarkers we evaluated, we showed that the amount of viral RNA in the blood was directly associated with mortality and provided the best predictive response, once our model was adjusted for the age and sex of the patient,” co-first author Elsa Brunet-Ratnasingham, a doctoral student in Kaufmann’s lab, said in a news release.
Including additional biomarkers did not improve predictive quality, she noted.
The researchers confirmed their findings in two independent cohorts of COVID-19 patients.
Currently, the amount of SARS-CoV-2 viral RNA in blood is not routinely measured in hospitalized COVID patients, Dr. Kaufmann told Reuters Health.
“However, this kind of measurement is routinely done for other viral infections, such as HIV. Therefore, if more research data support a clinical application, this kind of test could be rapidly implemented,” he said.
“For now, it is too early to say whether measurement of SARS-CoV-2 vRNA in plasma may have direct implications for care. To determine this, a critical clinical research step is to determine how this indicator (and other parameters we measured in this study) varies with the new therapies that are now given to patients with severe COVID-19,” Dr. Kaufmann said.
“A key question is: can monitoring of blood vRNA be used to follow the impact of these new treatments in patients? We are currently investigating this in a new study,” he added.
SOURCE: https://bit.ly/3cWJ8Gq Science Advances, online November 26, 2021.
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