Robert Klatt
The viral RNA in the blood of Covid 19 patients enables a more precise prediction of the course of the disease than the classic prognostic instruments used in intensive care medicine.
Montreal (Canada). In hospitalized Covid-19 patients, the further course of the disease has so far been difficult to predict. So far, the best indicators for this have been the increase in C-reactive protein, the viral load in the smear and some cytokines of the inflammatory reaction. Some studies also provided evidence that the concentration of virus RNA in the blood could also be used to predict the course of the disease. However, medicine has not yet been able to clarify whether this is viral debris that has entered the bloodstream from the lungs or whether the RNA comes from inactive viruses.
Scientist the University of Montreal around Daniel Kaufmann have now investigated in more detail whether and how the course of the disease can be predicted on the basis of the virus RNA in the blood. According to their publication in the specialist magazine Science Advances they investigated the influence of viral RNA in three groups.
Blood test on the eleventh day with Covid-19
The blood samples used for this were taken from all subjects on the eleventh day of the symptomatic Covid-19 infection. The patients were then observed for at least 60 days. It was thus possible to determine that the risk of death, as expected, was increased in subjects with an increased formation of cytokines and a weak antibody response.
However, the association with a high risk of death was even stronger with the concentration of virus RNA in the serum. According to the researchers, this even surpassed the classic prognostic instruments used in intensive care medicine, such as CRP (C-reactive protein), qSOFA (“quick sequential organ failure assessment”) and the Horowitz index (quotient of arterial oxygen partial pressure and inspiratory oxygen concentration).
Virus RNA and age allow accurate prognosis
The combination of the age and the viral RNA in the blood of the patient enables the best predictive value in the ROC analysis (“receiver operating characteristic”), which combines the specificity and sensitivity. An AUC value (“area under the curve”) of 0.85 was achieved. An AUC value of 1.0 would be perfect. An AUC value of 0.5, on the other hand, would be a purely coincidental result.
The results thus show that the viral load is probably the most important prognostic parameter for the course of Covid-19 disease. Because the number of subjects in the study was relatively small, the results will now be tested with other cohorts.
Science Advances, doi: 10.1126/sciadv.abj5629
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