SARS-CoV-2 RNA detected in blood samples from patients with COVID-19 is not associated with infectious virus
SARS-CoV-2 RNA detected in blood samples from patients with COVID-19 is not associated with infectious virus
ABSTRACT BackgroundLaboratory diagnosis of SARS-CoV-2 infection (the cause of COVID-19) uses PCR to detect viral RNA (vRNA) in respiratory samples. SARS-CoV-2 RNA has also been detected in other sample types, but there is limited understanding of the clinical or laboratory significance of its detection in blood. MethodsWe undertook a systematic literature review to assimilate the evidence for the frequency of vRNA in blood, and to identify associated clinical characteristics. We performed RT-PCR in serum samples from a UK clinical cohort of acute and convalescent COVID-19 cases (n=212), together with convalescent plasma samples collected by NHS Blood and Transplant (NHSBT) (n=111 additional samples). To determine whether PCR-positive blood samples could pose an infection risk, we attempted virus isolation from a subset of RNA-positive samples. ResultsWe identified 28 relevant studies, reporting SARS-CoV-2 RNA in 0-76% of blood samples; pooled estimate 10% (95%CI 5-18%). Among serum samples from our clinical cohort, 27/212 (12.7%) had SARS-CoV-2 RNA detected by RT-PCR. RNA detection occurred in samples up to day 20 post symptom onset, and was associated with more severe disease (multivariable odds ratio 7.5). Across all samples collected ≥28 days post symptom onset, 0/143 (0%, 95%CI 0.0-2.5%) had vRNA detected. Among our PCR-positive samples, cycle threshold (ct) values were high (range 33.5-44.8), suggesting low vRNA copy numbers. PCR-positive sera inoculated into cell culture did not produce any cytopathic effect or yield an increase in detectable SARS-CoV-2 RNA. ConclusionsvRNA was detectable at low viral loads in a minority of serum samples collected in acute infection, but was not associated with infectious SARS-CoV-2 (within the limitations of the assays used). This work helps to inform biosafety precautions for handling blood products from patients with current or previous COVID-19.
Peto Timothy、Dold Christina、Downs Louise O、Jaramillo Javier Gilbert、Harvala Heli、James Tim、James William、Jeffery Katie、Liu Xu、Matthews Philippa C、McNaughton Anna L、Mongkolsapaya Juthathip、Ploeg Rutger J、Andersson Monique I、Arancibia-C¨￠rcamo Carolina V、Baillie J Kenneth、Rudkin Justine、Bibi Sagida、Semple Malcolm G、Turtle Lance、Lumley Sheila F、Wareing Sue、Roberts David J、Barnes Eleanor、Justice Anita、Crook Derrick、Klenerman Paul、Eyre David W、Screaton Gavin、Auckland Kathryn、Carroll Miles、Dingle Kate、Ratcliff Jeremy、Oliveira Marta S、Dunn Laura、Beneke Tom、Simmonds Peter、Ijaz Samreen、Zambon Maria、Hoosdally Sarah、Knight Michael、Stoesser Nicole、Oakley Sarah、Knight Julian、Skelly Donal、Russell Rebecca A、Mentzer Alexander J
Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe HospitalDepartment of Paediatrics, University of Oxford, John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalSir William Dunn School of Pathology, University of OxfordNHS Blood and Transfusion||University College LondonOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalSir William Dunn School of Pathology, University of OxfordOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalSir William Dunn School of Pathology, University of OxfordOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe HospitalNuffield Department of Medicine, John Radcliffe HospitalNuffield Department of Medicine, John Radcliffe HospitalNHS Blood and Transfusion, John Radcliffe Hospital||Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalNuffield Department of Medicine, John Radcliffe Hospital||Translational Gastroenterology Unit, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe HospitalRoslin Institute, The University of Edinburgh, Easter Bush CampusBig Data Institute||Nuffield Department of Population Health, University of Oxford Richard Doll BuildingDepartment of Paediatrics, University of Oxford, John Radcliffe HospitalNIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Faculty of Health and Life Sciences, University of LiverpoolNIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Faculty of Health and Life Sciences, University of LiverpoolOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalNHS Blood and Transfusion, John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe Hospital||Big Data InstituteNuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe HospitalNuffield Department of Medicine, John Radcliffe HospitalPorton Down, Public Health EnglandNuffield Department of Medicine, John Radcliffe HospitalNuffield Department of Medicine, John Radcliffe HospitalPublic Health England||NHS Blood and Transfusion, John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalSir William Dunn School of Pathology, University of OxfordOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe HospitalPublic Health EnglandPublic Health EnglandNuffield Department of Medicine, John Radcliffe HospitalSir William Dunn School of Pathology, University of OxfordOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe HospitalOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe HospitalSir William Dunn School of Pathology, University of OxfordOxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital||Nuffield Department of Medicine, John Radcliffe Hospital||NIHR Oxford Biomedical Research Centre (BRC), John Radcliffe Hospital
医学研究方法基础医学微生物学
COVID-19SARS-CoV-2viral loadviraemiaRNAbloodserumplasmaseveritybiomarkerlaboratory safety
Peto Timothy,Dold Christina,Downs Louise O,Jaramillo Javier Gilbert,Harvala Heli,James Tim,James William,Jeffery Katie,Liu Xu,Matthews Philippa C,McNaughton Anna L,Mongkolsapaya Juthathip,Ploeg Rutger J,Andersson Monique I,Arancibia-C¨￠rcamo Carolina V,Baillie J Kenneth,Rudkin Justine,Bibi Sagida,Semple Malcolm G,Turtle Lance,Lumley Sheila F,Wareing Sue,Roberts David J,Barnes Eleanor,Justice Anita,Crook Derrick,Klenerman Paul,Eyre David W,Screaton Gavin,Auckland Kathryn,Carroll Miles,Dingle Kate,Ratcliff Jeremy,Oliveira Marta S,Dunn Laura,Beneke Tom,Simmonds Peter,Ijaz Samreen,Zambon Maria,Hoosdally Sarah,Knight Michael,Stoesser Nicole,Oakley Sarah,Knight Julian,Skelly Donal,Russell Rebecca A,Mentzer Alexander J.SARS-CoV-2 RNA detected in blood samples from patients with COVID-19 is not associated with infectious virus[EB/OL].(2025-03-28)[2025-06-21].https://www.medrxiv.org/content/10.1101/2020.05.21.20105486.点此复制
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