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SARS-CoV-2 RNAaemia in children: An Iranian referral hospital-based study
Babak Pourakbari1, Shima Mahmoudi1, Yasmine Mahmoudieh2
1Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
SARS-CoV-2 RNA in blood (RNAaemia) was found in 6% of pediatric COVID-19 patients. RNAaemia was linked to severe disease, mortality, and altered magnesium and creatine phosphokinase levels.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Clinical Diagnostics
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is typically detected in nasopharyngeal swabs, but can also be found in blood (RNAaemia).
- Associations between SARS-CoV-2 RNAaemia and severe disease or mortality are established in adults, but data in pediatric populations are lacking.
- Understanding SARS-CoV-2 RNAaemia in children is crucial for assessing disease severity and outcomes.
Purpose of the Study:
- To evaluate the association between SARS-CoV-2 RNAaemia and mortality, disease severity, and clinical/laboratory findings in pediatric patients.
- To identify potential biomarkers for predicting SARS-CoV-2 RNAaemia in children with COVID-19.
Main Methods:
- Retrospective analysis of 96 pediatric patients with confirmed COVID-19.
- Detection of SARS-CoV-2 RNA in blood samples.
- Comparison of clinical symptoms, disease severity, and laboratory test results (including creatine phosphokinase and magnesium) between patients with and without RNAaemia.
Main Results:
- SARS-CoV-2 RNAaemia was detected in 6% (6/96) of pediatric patients.
- Patients with RNAaemia had a higher incidence of severe COVID-19 (67%) and mortality (33%).
- Symptoms like fever, cough, tachypnea, and vomiting were more prevalent in patients with RNAaemia. Significant differences in creatine phosphokinase and magnesium levels were observed.
Conclusions:
- SARS-CoV-2 RNAaemia in pediatric patients is associated with severe COVID-19 and increased mortality.
- Magnesium and creatine phosphokinase levels may serve as predictive markers for SARS-CoV-2 RNAaemia in children.
- Further research is warranted to elucidate the role of RNAaemia and these biomarkers in pediatric COVID-19 management.
Abstract:
Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is generally detected in nasopharyngeal swabs, viral RNA can be found in other samples including blood. Recently, associations between SARS-CoV-2 RNAaemia and disease severity and mortality have been reported in adults, while no reports are available in pediatric patients with coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the mortality, severity, clinical, and laboratory findings of SARS-CoV-2 RNA detection in blood in 96 pediatric patients with confirmed COVID-19. Among all patients, 6 (6%) had SARS-CoV-2 RNAaemia. Out of the six patients with SARS-CoV-2 RNAaemia, four (67%) had a severe form of the disease, and two out of the 6 patients with SARS-CoV-2 RNAaemia passed away (33%). Our results show that the symptoms more commonly found in the cases of COVID-19 in the study (fever, cough, tachypnea, and vomiting), were found at a higher percentage in the patients with SARS-CoV-2 RNAaemia. Creatine phosphokinase and magnesium tests showed significant differences between the positive and negative SARS-CoV-2 RNAaemia groups. Among all laboratory tests, magnesium and creatine phosphokinase could better predict SARS-CoV-2 RNAemia with area under the curve levels of 0.808 and 0.748, respectively. In conclusion, 67% of individuals with SARS-CoV-2 RNAaemia showed a severe COVID-19 and one-third of the patients with SARS-CoV-2 RNAaemia passed away. Our findings suggest that magnesium and creatine phosphokinase might be considered as markers to estimate the SARS-CoV-2 RNAaemia.