Detectable 2019-nCoV viral RNA in blood is a strong indicator for the further clinical severity

Abstract

The novel coronavirus (2019-nCoV) infection caused pneumonia. we retrospectively analyzed the virus presence in the pharyngeal swab, blood, and the anal swab detected by real-time PCR in the clinical lab. Unexpectedly, the 2109-nCoV RNA was readily detected in the blood (6 of 57 patients) and the anal swabs (11 of 28 patients). Importantly, all of the 6 patients with detectable viral RNA in the blood cohort progressed to severe symptom stage, indicating a strong correlation of serum viral RNA with the disease severity (p-value = 0.0001). Meanwhile, 8 of the 11 patients with annal swab virus-positive was in severe clinical stage. However, the concentration of viral RNA in the anal swab (Ct value = 24 + 39) was higher than in the blood (Ct value = 34 + 39) from patient 2, suggesting that the virus might replicate in the digestive tract. Altogether, our results confirmed the presence of virus RNA in extra-pulmonary sites.

Keywords: 2019-ncov; anal swab; blood viral RNA; laboratory test; pharyngeal swab.

Figures

Figure 1.

Results of 2019-nCoV viral RNA detection in the blood (A) and anal swab (B). Blood or anal swab positive represents viral RNA positive in at least one test of blood or anal swab samples from the same patient. Blood or anal swab negative represents viral RNA negative in all tests of blood or anal swab samples from the same patient. Severe represents that the patient is diagnosed as a severe symptom after expert consultation while mild represents the rest of the patients. P values are shown (chi-square test, two sides).

Figure 2.

Diagram of viral detection in patient 1 (A) and 2 (B) with both detectable virus RNA in blood and anal swab. Illness day represents the patients with clear clinical symptoms such as fever, dry-coughing is labelled over the first line. ICU, CDC confirmed, and transfer indicates that the patient is in the ICU ward, CDC confirmation of viral positive, and transfer of patient out from ICU ward to another hospital to receive a higher level of medical care, respectively. Ct value from the pharyngeal, blood and the anal swab is shown.

Figure 3.

Diagram of viral detection in Patient 3 (A), 4 (B), 5 (C) and 6 (D) with both detectable virus RNA in blood. Labels are identical to those in Figure 2. Severe represents that the patient is diagnosed to be severe symptoms (B). Infection day represents the patient with a clear time of infection (D).