Occurrence and clinical correlates of SARS-CoV-2 viremia in two German patient cohorts

Viremia defined as detectable SARS-CoV-2 RNA in the blood is a potential marker of disease severity and prognosis in COVID-19 patients. Here, we determined the frequency of viremia in serum of two independent COVID-19 patient cohorts within the German National Pandemic Cohort Network (German: <b>Na</b>tionales <b>P</b>andemie <b>Ko</b>horten <b>N</b>etzwerk, NAPKON) with diagnostic RT-PCR against SARS-CoV-2. A cross-sectional cohort with 1122 COVID-19 patients (German: <b><i>S</i></b><i>ektoren<b>ue</b>bergreifende <b>P</b>latform</i>, SUEP) and 299 patients recruited in a high-resolution platform with patients at high risk to develop severe courses (German: <b><i>H</i></b><i>och<b>a</b>ufloesende <b>P</b>lattform</i>, HAP) were tested for viremia. Our study also involved a comprehensive analysis and association of serological, diagnostic, and clinical parameters of the NAPKON medical dataset. Prevalence of viremia at the recruitment visit was 12.8% (SUEP) and 13% (HAP), respectively. Serological analysis revealed that viremic patients had lower levels of SARS-CoV-2 specific antibodies as well as lower neutralizing antibodies compared to aviremic patients. Viremia was associated with severity (<0.0001 SUEP; 0.002 HAP) and mortality of COVID-19 (both cohorts <0.0001) compared to aviremic patients. While rare, viremia was also detected in patients with mild disease (0.7%). In patients of the SUEP cohort with acute kidney disease (<i>p</i> = 0.0099) and hematooncological conditions (<i>p</i> = 0.0091), viremia was detected more frequently. Compared to the aviremic group, treatment with immunomodulating drugs as well as elevated levels of inflammatory markers in the blood was more frequent in the viremic group. In conclusion, our analysis revealed that detectable viremia correlates with hyperinflammatory conditions and higher risk for severe COVID-19 disease.

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Publication Details

Journal
Emerging Microbes & Infections
Published
2025-01-27
DOI
https://doi.org/10.1080/22221751.2025.2459137
Citations
1
Primary Topic
COVID-19 Clinical Research Studies
Type
article
Field-Weighted Citation Impact
1.40

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article

Occurrence and clinical correlates of SARS-CoV-2 viremia in two German patient cohorts

Dagmar Krefting, Sabine Blaschke, Susana M. Nunes de Miranda, Carolin Nürnberger et al.
1 citations
Emerging Microbes & Infections
COVID-19 Clinical Research Studies
1.40
article

Occurrence and clinical correlates of SARS-CoV-2 viremia in two German patient cohorts

Dagmar Krefting, Sabine Blaschke, Susana M. Nunes de Miranda, Carolin Nürnberger, Margarete Scherer, Katharina Grikscheit, Peter U. Heuschmann, Jörg Janne Vehreschild, Axel Hamprecht, Edgar Dahl, Gabriele Anton, Björn‐Erik Ole Jensen, Robert Bals, Sina M. Hopff, Katharina S. Appel, Holger F. Rabenau, Caitlin Pley, Annemarie Berger, Niko Kohmer, Sandra Ciesek, Thomas Illig, Patrick Meybohm
article en
1 citations

Abstract

Viremia defined as detectable SARS-CoV-2 RNA in the blood is a potential marker of disease severity and prognosis in COVID-19 patients. Here, we determined the frequency of viremia in serum of two independent COVID-19 patient cohorts within the German National Pandemic Cohort Network (German: <b>Na</b>tionales <b>P</b>andemie <b>Ko</b>horten <b>N</b>etzwerk, NAPKON) with diagnostic RT-PCR against SARS-CoV-2. A cross-sectional cohort with 1122 COVID-19 patients (German: <b><i>S</i></b><i>ektoren<b>ue</b>bergreifende <b>P</b>latform</i>, SUEP) and 299 patients recruited in a high-resolution platform with patients at high risk to develop severe courses (German: <b><i>H</i></b><i>och<b>a</b>ufloesende <b>P</b>lattform</i>, HAP) were tested for viremia. Our study also involved a comprehensive analysis and association of serological, diagnostic, and clinical parameters of the NAPKON medical dataset. Prevalence of viremia at the recruitment visit was 12.8% (SUEP) and 13% (HAP), respectively. Serological analysis revealed that viremic patients had lower levels of SARS-CoV-2 specific antibodies as well as lower neutralizing antibodies compared to aviremic patients. Viremia was associated with severity (<0.0001 SUEP; 0.002 HAP) and mortality of COVID-19 (both cohorts <0.0001) compared to aviremic patients. While rare, viremia was also detected in patients with mild disease (0.7%). In patients of the SUEP cohort with acute kidney disease (<i>p</i> = 0.0099) and hematooncological conditions (<i>p</i> = 0.0091), viremia was detected more frequently. Compared to the aviremic group, treatment with immunomodulating drugs as well as elevated levels of inflammatory markers in the blood was more frequent in the viremic group. In conclusion, our analysis revealed that detectable viremia correlates with hyperinflammatory conditions and higher risk for severe COVID-19 disease.

Emerging Microbes & InfectionsVol. 14(1)
Goethe University Frankfurt (DE), Carl von Ossietzky Universität Oldenburg (DE), University of Cologne (DE), Bielefeld University (DE), University of Würzburg (DE), Medizinische Hochschule Hannover (DE), Düsseldorf University Hospital (DE), Zimmer Biomet (Germany) (DE), German Center for Infection Research (DE), Universitätsmedizin Göttingen (DE), Helmholtz Centre for Infection Research (DE), Universitätsklinikum Würzburg (DE), Cardiovascular Center Frankfurt (DE), University Hospital Frankfurt (DE), Fraunhofer Institute for Molecular Biology and Applied Ecology (DE), Helmholtz Institute for Pharmaceutical Research Saarland (DE), University Hospital Cologne (DE), Heinrich Heine University Düsseldorf (DE), Charité - Universitätsmedizin Berlin (DE), RWTH Aachen University (DE), Saarland University (DE)
Bundesministerium für Bildung und Forschung, Universität Bielefeld
Good health and well-being
Openalex Percentile: Top 25%
COVID-19 Clinical Research Studies
1.40
DOIOpen Access PDFOpenAlex
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