{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T12:00:29Z","timestamp":1786449629603,"version":"build-2736575974"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP19fk0108104j0801"],"award-info":[{"award-number":["JP19fk0108104j0801"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>This study aimed to clarify how SARS-CoV-2 RNAemia is related to COVID-19 critical condition development and mortality in comparison with other predictive markers and scoring systems.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a retrospective cohort study conducted at Yokohama Municipal Citizen\u2019s Hospital and National Institute of Infectious Diseases. We recruited adult patients with COVID-19 admitted between March 2020 and January 2021. We compared RNAemia with clinical status on admission including scoring systems such as the 4C Mortality, CURB-65, and A-DROP, as well as the C<jats:sub>t<\/jats:sub> value of the nasopharyngeal PCR, in predicting COVID-19 mortality and critical condition development.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 92 recruited patients (median age, 58; interquartile range, 45\u201371 years), 14 (14.9%) had RNAemia. These patients had an older age (median, 68 years vs. 55.5 years; <jats:italic>p<\/jats:italic> = 0.011), higher values of lactated dehydrogenase (median, 381 U\/L vs. 256.5 U\/L, <jats:italic>p<\/jats:italic> &lt; 0.001), C-reactive protein (median, 10.9 mg\/dL vs. 3.8 mg\/dL; <jats:italic>p<\/jats:italic> &lt; 0.001), D-dimer (median, 2.07 \u03bcg\/mL vs. 1.28 \u03bcg\/mL; <jats:italic>p<\/jats:italic> = 0.015), lower values of lymphocyte (median, 802\/\u03bcL vs. 1007\/\u03bcL, <jats:italic>p<\/jats:italic> = 0.025) and C<jats:sub>t<\/jats:sub> of the nasopharyngeal PCR assay (median, 20.59 vs. 25.54; <jats:italic>p<\/jats:italic> = 0.021) than those without RNAemia. Univariate analysis showed RNAemia was associated with mortality (odds ratio [OR], 18.75; 95% confidence interval [CI], 3.92\u201389.76; area under the receiver operating characteristic curve [AUC], 0.7851; <jats:italic>p<\/jats:italic> = 0.002) and critical condition (OR, 72.00; 95% CI, 12.98\u2013399.29; AUC, 0.8198; <jats:italic>p<\/jats:italic> &lt; 0.001). Plus, multivariate analysis also revealed the association of RNAemia with critical condition (adjusted OR, 125.71; 95% CI, 11.47\u20131377.32; <jats:italic>p<\/jats:italic> &lt; 0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>On-admission SARS-CoV-2 RNAemia is a potent predictive marker of COVID-19 critical condition and mortality. The adjusted OR for critical condition was as high as 125.71.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0254640","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T17:26:02Z","timestamp":1626197162000},"page":"e0254640","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["On-admission SARS-CoV-2 RNAemia as a single potent predictive marker of critical condition development and mortality in 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