SARS-CoV-2 RNAaemia in children: An Iranian referral hospital-based study

J Med Virol. 2021 Sep;93(9):5452-5457. doi: 10.1002/jmv.27065. Epub 2021 May 15.

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.

Keywords: COVID-19; RNAaemia; SARS-CoV-2; pediatrics; severity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • COVID-19 / diagnosis
  • COVID-19 / mortality
  • COVID-19 / pathology*
  • COVID-19 / virology
  • COVID-19 Nucleic Acid Testing
  • Child
  • Child, Preschool
  • Cough / diagnosis
  • Cough / mortality
  • Cough / pathology
  • Cough / virology
  • Creatine Kinase / blood*
  • Female
  • Fever / diagnosis
  • Fever / mortality
  • Fever / pathology
  • Fever / virology
  • Hospitals
  • Humans
  • Infant
  • Infant, Newborn
  • Iran
  • Magnesium / blood*
  • Male
  • RNA, Viral / blood*
  • RNA, Viral / genetics
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / pathogenicity*
  • Severity of Illness Index
  • Survival Analysis
  • Tachypnea / diagnosis
  • Tachypnea / mortality
  • Tachypnea / pathology
  • Tachypnea / virology
  • Viremia / diagnosis
  • Viremia / mortality
  • Viremia / pathology*
  • Viremia / virology

Substances

  • Biomarkers
  • RNA, Viral
  • Creatine Kinase
  • Magnesium