{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T02:27:50Z","timestamp":1786415270365,"version":"build-2736575974"},"reference-count":24,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Defense Health Program","award":["HU00012020067"],"award-info":[{"award-number":["HU00012020067"]}]},{"name":"Defense Health Program","award":["HU00012120103"],"award-info":[{"award-number":["HU00012120103"]}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Disease","doi-asserted-by":"publisher","award":["HU00011920111"],"award-info":[{"award-number":["HU00011920111"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Disease","doi-asserted-by":"publisher","award":["Y1-AI-5072"],"award-info":[{"award-number":["Y1-AI-5072"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Infectious Disease Clinical Research Program"},{"name":"IDCRP"},{"name":"Department of War"},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003896","name":"Henry M. Jackson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003896","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Advancement of Military Medicine, Inc"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in blood has been proposed as a marker of severe coronavirus disease 2019 (COVID-19), but it is unclear whether RNAemia mediates the pathway toward worsening disease. We hypothesized that RNAemia is associated with severe disease and distinct gene expression patterns are associated with RNAemia and severe COVID-19. These RNAemia-associated patterns may identify COVID-19 treatment targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 202 hospitalized COVID-19 participants from a multicenter US Military Health System cohort using digital droplet polymerase chain reaction to quantify SARS-CoV-2 RNA in plasma and performed host RNA sequencing of peripheral blood. Differential gene expression logistic regression models were used to assess associations among RNAemia, host gene expression, and disease severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>RNAemia was detected in 39.1% of participants and was associated with severe disease (54% vs 32% in RNAemia-negative participants; P &amp;lt; .001). In final adjusted models, independent predictors of severity included RNAemia (adjusted odds ratio [aOR] range 1.99\u20132.24, all P \u2264 .04), as well as host genes ADAMTS2 (aOR = 1.58, P &amp;lt; .001), OLAH (aOR = 1.55, P &amp;lt; .001), and PCSK9 (aOR = 1.60, P &amp;lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RNAemia is an independent predictor of COVID-19 severity. However, host gene expression changes associated with RNAemia, particularly involving OLAH, PCSK9, and ADAMTS2, had stronger statistical evidence of severe outcomes than RNAemia itself. PCSK9 is an intervenable treatment target worth further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag390","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T11:41:17Z","timestamp":1784979677000},"source":"Crossref","is-referenced-by-count":0,"title":["RNAemia and Severe Coronavirus Disease 2019: Candidate Treatment Targets Identified Through Transcriptomics"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1641-0377","authenticated-orcid":false,"given":"Sultanah","family":"Alharthi","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center , Nashville, Tennessee ,","place":["USA"]},{"name":"Henry M. 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