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MeSH Disease

HGNC Genes

SARS-CoV-2 proteins

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    SARS-CoV-2 RNA detected in blood samples from patients with COVID-19 MESHD is not associated with infectious virus

    Authors: Monique Andersson; Carolina V Arancibia - Carcamo; Kathryn Auckland; J Kenneth Baillie; Eleanor Barnes; Tom Beneke; Sagida Bibi; Miles Carroll; Derrick Crook; Kate Dingle; Christina Dold; Louise O Downs; Laura Dunn; David W Eyre; Javier Gilbert Jaramillo; Heli Harvala; Sarah Hoosdally; Samreen Ijaz; Tim James; William James; Katie Jeffery; Anita Justice; Paul Klenerman; Julian C Knight; Michael Knight; Xu Liu; Sheila F Lumley; Philippa C Matthews; Anna L McNaughton; Alexander J Mentzer; Juthathip Mongkolsapaya; Sarah Oakley; Marta S Oliveira; Timothy Peto; Rutger J Ploeg; Jeremy Ratcliff; David J Roberts; Justine Rudkin; Rebecca A Russell; Gavin Screaton; Malcolm G Semple; Donal T Skelly; Peter Simmonds; Nicole Stoesser; Lance Turtle; Sue Wareing; Maria Zambon

    doi:10.1101/2020.05.21.20105486 Date: 2020-05-26 Source: medRxiv

    Background: Laboratory diagnosis of SARS-CoV-2 infection MESHD (the cause of COVID-19 MESHD) uses PCR to detect viral RNA ( vRNA HGNC) 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. Methods: We undertook a systematic literature review to assimilate the evidence for the frequency of vRNA HGNC 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 MESHD 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. Results: We 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 HGNC detected. Among our PCR-positive samples, cycle threshold (ct) values were high (range 33.5-44.8), suggesting low vRNA HGNC 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. Conclusions: vRNA HGNC was detectable at low viral loads in a minority of serum samples collected in acute infection MESHD, but was not associated with infectious SARS-CoV-2 MESHD (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 MESHD.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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