Lower respiratory tract and plasma SARS-CoV-2 RNA load in critically ill adult COVID-19 patients: Relationship with biomarkers of disease severity

  1. Beatriz Olea
  2. Eliseo Albert
  3. Ignacio Torres
  4. Roberto Gozalbo-Rovira
  5. Nieves Carbonell
  6. José Ferreres
  7. Sandrine Poujois
  8. Rosa Costa
  9. Javier Colomina
  10. Jesús Rodríguez
  11. María Luisa Blasco
  12. David Navarro

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Abstract

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  1. Version published to 10.1016/j.jinf.2021.05.036
  2. ScreenIT

    SciScore for 10.1101/2021.04.16.21255601: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The current study was approved by the Ethics Committee of Hospital Clínico Universitario INCLIVA (
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablePatients and specimens: In this prospective observational study, 73 consecutive critically ill COVID-19 patients (51 males and 22 females; median age, 65 years; range, 21 to 80 years) were recruited during ICU stay between October 2020 and February 2021 (Table 1).

    Table 2: Resources

    Antibodies
    SentencesResources
    Depleting experiments using a rabbit anti-N protein antibody (40143-R019; SinoBiological) confirmed the true nature of SARS-CoV-2 N detected in a number of discordant plasma specimens (testing negative by RT-PCR), as described in supplementary methods and shown in Supplementary Fig. 2.
    anti-N protein
    suggested: None
    Software and Algorithms
    SentencesResources
    Nucleic acid extraction was performed using a magnetic microparticle-based protocol (Abbott mSample Preparation SystemDNA) on the Abbott m2000sp platform (Abbott Molecular (Des Plaines, IL, USA) with a starting sample volume of 400 µl.
    Abbott
    suggested: (Abbott, RRID:SCR_010477)
    The analyses were performed using SPSS version 20.0 (SPSS, Chicago, IL, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The main limitations of the current study are the relatively small sample size, the non-negligible number of missing specimens, specially TA, compared with the planned sample collection schedule, and analytical methods which may have underestimated the viral RNAemia and N-antigenemia detection rate. Analysis of sequential specimens from patients could be considered a strength of the research. The current study contributes to filling a knowledge gap on the comparative dynamics of SARS-CoV-2 in LRT and in the systemic compartment in ICU patients, and provides further insight into the pathogenesis of SARS-CoV-2 infection in this patient subset. In this respect, whether poor clinical outcomes in critically ill patients are directly linked to the extent of virus replication in the LRT, to a dysregulated pro-inflammatory state (cytokine storm) [4,5], or both, remains to be elucidated. In our view, our data fit better with a pathogenetic model, in which SARS-CoV-2 replication in the LRT or its presence in the blood compartment at a certain point over the course of ICU stay might not be a major driver of systemic inflammation, lymphopenia, lung dysfunction, multisystemic organ failure and death. This does not invalidate the importance of virus replication rate in the URT in the early stage after infection in determining the clinical course of COVID-19 [6-8]. Further studies are needed to resolve this issue.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.04.16.21255601 on medRxiv