• Plos One · Jan 2020

    Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study.

    • Tobias Schlesinger, Benedikt Weißbrich, Florian Wedekink, Quirin Notz, Johannes Herrmann, Manuel Krone, Magdalena Sitter, Benedikt Schmid, Markus Kredel, Jan Stumpner, Lars Dölken, Jörg Wischhusen, Peter Kranke, Patrick Meybohm, and Christopher Lotz.
    • Department of Anesthesiology and Critical Care, University Hospital of Wuerzburg, Wuerzburg, Germany.
    • Plos One. 2020 Jan 1; 15 (11): e0242917.

    BackgroundThe viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS).MethodsThis is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay.ResultsMost patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009).ConclusionsCOVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.

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