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Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study
Tobias Schlesinger1, Benedikt Weißbrich2, Florian Wedekink3
1Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.
Plos One
|November 24, 2020
Summary
Severe COVID-19 patients with ARDS had high SARS-CoV-2 viral loads in tracheal aspirates. Antibody levels did not correlate with survival, and the virus was undetectable in dialysate.
Area of Science:
- Virology
- Immunology
- Critical Care Medicine
Background:
- Investigating viral load and tissue distribution of SARS-CoV-2 is crucial.
- Understanding these factors in severe COVID-19 patients with ARDS is essential.
Purpose of the Study:
- To investigate SARS-CoV-2 viral load, biodistribution, and antibody formation in severe COVID-19 patients with ARDS.
- To analyze the relationship between viral load, antibody response, and clinical outcomes.
Main Methods:
- Retrospective single-center study of 23 COVID-19 ARDS patients.
- SARS-CoV-2 viral load assessed using RT-qPCR on 478 samples (tracheal aspirates, oropharyngeal swabs, blood, dialysate).
- Anti-SARS-CoV-2-Spike-RBD antibody levels (IgM, IgA) measured by ELISA.
Main Results:
- High SARS-CoV-2 detection in tracheal aspirates (100%) and oropharyngeal swabs (77%).
- Blood samples showed SARS-CoV-2 RNA in 26% of patients; virus was never detected in dialysate.
- Lower neutralizing IgM and IgA antibody concentrations were observed in survivors compared to non-survivors (p=0.009).
Conclusions:
- Severe COVID-19 ARDS is characterized by high SARS-CoV-2 viral load in tracheal aspirates, persisting throughout ICU treatment.
- SARS-CoV-2 RNAemia occurred without detectable virus in dialysate.
- Neither viral load nor neutralizing antibody levels were associated with 30-day survival or disease severity.
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