Temporal kinetics of RNAemia and associated systemic cytokines in hospitalized COVID-19 patients

van Riel, Debby; Embregts, Carmen W.E.; Sips, Gregorius J.; van den Akker, Johannes P.C.; Endeman, Henrik; van Nood, Els; van Kampen, Jeroen; Molenkamp, Richard; Koopmans, Marion; van de Vijver, David; GeurtsvanKessel, Corine H.

COVID-19 is associated to a wide range of extra-respiratory complications, of which the pathogenesis is currently not fully understood. In this study we report the temporal kinetics of viral RNA and inflammatory cytokines and chemokines in serum during the course of COVID-19. We show that a RNAemia occurs more frequently and lasts longer in patients that develop critical disease compared to patients that develop moderate or severe disease. Furthermore we show that concentrations of IL-10 and MCP-1—but not IL-6—are associated with viral load in serum. However, higher levels of IL-6 were associated with the development of critical disease. The direct association of inflammatory cytokines with viral load or disease severity highlights the complexity of systemic inflammatory response and the role of systemic viral spread.