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

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

PloS one (2020-11-25)
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, Christopher Lotz
ABSTRACT

The 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). This 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. Most 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). COVID-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.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
IgA from human serum, reagent grade, ≥95% (HPLC), buffered aqueous solution
Sigma-Aldrich
IgM from human serum, reagent grade, ~95% (HPLC), buffered aqueous solution
Sigma-Aldrich
IgG from human serum, reagent grade, ≥95% (HPLC), buffered aqueous solution