SARS-CoV-2 RNAemia is associated with severe chronic underlying diseases but not with nasopharyngeal viral load

The kinetics of the SARS-CoV-2 viral load in respiratory airways and other tissues is of great interest to understand the pathogenesis, course, and the management of COVID-19 patients. Therefore, we read with much interest the systematic literature review recently published in the Journal of Infection by Walsh et al.1, concluding that viral load in upper respiratory samples peaks around the time of symptoms onset or a few days thereafter, and becomes undetectable about two weeks after symptom onset; moreover, there is evidence of prolonged virus detection in stool samples, with unclear clinical significance. Information regarding the use of other samples to improve patients’ management is lacking or inconsistent.1, 2, 3 Thus, the risk factors for bloodstream infection and the clinical meaning of SARS-CoV-2 RNAemia detection has not yet been completely elucidated.Supported by Plan Nacional de I + D + i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI, RD16/0016/0001, RD16/0016/0005, RD16/0016/0007, RD16/0016/0009, RD16/0016/0010, R D16/0016/0013) cofinanced by European Development Regional Fund “A way to achieve Europe”, Operative program Intelligent Growth 2014–2020. JSC and EC received grants from the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación , Proyectos de Investigación sobre el SARS-CoV-2 y la enfermedad COVID-19 ( COV20/00580 ; COV20/00370 ). J.S.C. is a researcher belonging to the program “Nicolás Monardes” (C-0059–2018), Servicio Andaluz de Salud, Junta de Andalucía, Spain.Peer reviewe