Abstract
The pandemic caused by the SARS-CoV-2 infection affects many aspects of public health knowledge, science, and practice around the world. Several studies have shown that SARS-CoV-2 RNA in plasma seems to be associated with a worse prognosis of COVID-19. In the present study, we investigated plasma and buffy RNA in patients with COVID-19 to determine its prognostic value. A prospective study was carried out in patients hospitalized for COVID-19, in which RNA was analyzed in plasma and the buffy coat. Morphological and immunohistochemical studies were used to detect the presence of SARS-CoV-2 in the buffy coat. In COVID-19 patients, the obtained RNA concentration in plasma was 448.3 ± 31.30 ng/mL. Of all the patients with positive plasma tests for SARS-CoV-2, 46.15% died from COVID-19. In four cases, tests revealed that SARS-CoV-2 was present in the buffy coat. Abnormal morphology of monocytes, lymphocytes and neutrophils was found. An immunohistochemical study showed positivity in mononuclear cells and platelets. Our results suggest that SARS-CoV-2 is present in the plasma. This facilitates viral dissemination and migration to specific organs, where SARS-CoV-2 infects target cells by binding to their receptors. In our study, the presence of plasma SARS-CoV-2 RNA was correlated with worse prognoses.
Highlights
SARS-CoV-2 is the causative agent of COVID-19, an enveloped positive-sense singlestranded RNA virus that belongs to a large family of coronaviruses [1,2,3,4]
We found SARS-CoV-2 plasma RNA in thirteen COVID-19 patients (54.17%) who required care in the intensive care unit, of whom six (46.15%) died from COVID-19
These findings are supported by those of previous studies, in which SARS-CoV-2 plasma RNA was associated with a worse clinical prognosis in patients with COVID-19 [6,7,8,9,10,11,12,13,14,15,16]
Summary
SARS-CoV-2 is the causative agent of COVID-19, an enveloped positive-sense singlestranded RNA virus that belongs to a large family of coronaviruses [1,2,3,4]. The SARS-CoV-2 genome consists of 14 open reading frames (ORFs), 9 of which encode 16 non-structural proteins (nsp1–16) [4,5]. The remaining five frames encode nine accessory proteins (ORFs) and four structural proteins: spike (S), envelope (E), membrane (M), and nucleocapsid (N) [4,5]. The presence of SARS-CoV-2 in peripheral blood remains a matter of debate due to the implications it has during the disease and its correlation with prognostic and predictive factors. We investigated the presence of SARS-CoV-2 in both plasma and the buffy coat in order to understand the way in which the hematogenous spread of the virus occurs and explain the mechanisms of systemic viral involvement
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