Contrasting SARS-CoV-2 RNA copies and clinical symptoms in a large cohort of Colombian patients during the first wave of the COVID-19 pandemic

Abstract

Background There is limited and controverting evidence looking at possible associations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA copies and patient variables in large cohorts of symptomatic and asymptomatic patients. Methods We studied 2275 symptomatic and asymptomatic patients from Colombia with coronavirus disease 2019 (COVID-19) and analyzed the associations between RT-PCR cycle threshold (Ct) value with gender, age, comorbidities, symptomatology, and disease severity. Results 15.4 % of the samples (n = 428) reported at least one comorbidity. There were 2011 symptomatic cases (72.4 %), being the most common reported symptom cough (57.2 %, n = 1586). Respiratory distress was present in 21.4 % of patients (n = 595), and 435 patients (15.6 %) required hospital admission. We observed that patients with no prior medical history harbored higher RNA copies than patients with comorbidities (p = 0.02). No significant differences in RNA copies were observed between symptomatic and asymptomatic patients (p = 0.82). Strong correlations were detected between Ct values and the presence of odynophagia (p = 0.03), diarrhea (p = 0.04), and headache (p = 0.0008). An inverse association was found between RNA copy number and markers of disease severity, namely, respiratory distress (P < 0.0001) and hospitalization requirement (P < 0.0001). Conclusions SARS-CoV-2 RT-PCR cycle thresholds reveal strong associations with a prior medical history, specific symptomatology, and disease severity markers. Further research controlling potential confounding variables needs to be conducted to evaluate the nature and usefulness of these associations in managing COVID-19 patients.

Haematological and radiological-based prognostic markers of COVID-19

“…The utility of viral load in predicting mortality has been reported previously [ 41 ]; however, our study is based on Ct values, which do not directly implies the magnitude of viruses in the samples; and a further quantitative RT-PCR would be required to evaluate the precise viral load and its association with COVID-19 outcomes. There have been contradicting reports on the utility of Ct values in predicting the outcome of COVID-19 [ [42] , [43] , [44] , [45] ]. One report showed that higher viral RNA load in plasmas could predict mortality [ 46 ], but plasma viremia data were not available for our cohort.…”

Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

“…Qualitative variables were summarized in frequencies and proportions according to the infectious species and single- or coinfection patterns. Due to the distribution of the quantitative data, to identify the statistical significance of possible differences between the single-infection and coinfection groups, the nonparametric Mann-Whitney-Wilcoxon test was applied ( 69 ).…”

SARS-CoV-2 in Urine May Predict a Severe Evolution of COVID-19

“…The critical value of U at p < 0.05 is 45). At the presentation of the disease, 60 out of 75 patients had Ct values lower than 30 in the nasal swab with negative antibodies anti-SARS-CoV-2 and were considered in the acute phase of infection [ 8 ]. Out of 75 subjects, 15 were patients with Ct > 30 but lower than 35 and had a history of infection for more than 7 days with clinical worsening and were therefore excluded.…”

“…Indeed, while RT-PCR by a nasopharyngeal swab is effective for the diagnosis of COVID-19, little data exist to assess if it could correctly reflect the systemic disease severity and infectiousness to others and/or the expression of the ability of the immune system to contain a viral spread. Indeed, the relationship between SARS-CoV-2 detection, viral load and infectivity is not fully understood, as the presence of viral RNA may not represent transmissible live virus or the expression of the immune system’s defective response [ 7 , 8 , 9 , 10 ]. Even though our findings are on a small cohort of patients, they clearly suggest that a viral shedding in urine during natural history of disease is characterized by a worsening outcome of the patients regardless of organ function.…”

“…In particular, SARS-CoV-2 detection and viral load at different time points of infection, including in those without any symptoms, would help to better understand the disease evolution [6,7]. Indeed, while rRT-PCR by a nasopharyngeal swab is a well-defined method for the diagnosis of COVID-19, little data exist to assess the role of positive rRT-PCR in other biologic samples and its possible correlation with the disease severity and infectiousness to others [8][9][10]. In fact, disease severity is triggered by several predisposing factors, including viral shedding, that could be related to the immune response and infection control [11,12].…”