Viral Dynamics and Real-Time RT-PCR Ct Values Correlation with Disease Severity in COVID-19

Rabaan, Ali A.; Tirupathi, Raghavendra; Sule, Anupam A; Aldali, Jehad A.; Mutair, Abbas Al; Alhumaid, Saad; Muzaheed, .; Gupta, Nitin; Koritala, Thoyaja; Adhikari, Ramesh; Bilal, Muhammad; Dhawan, Manish; Tiwari, Ruchi; Mitra, Saikat; Emran, Talha Bin; Dhama, Kuldeep

doi:10.3390/diagnostics11061091

Cited by 171 publications

(155 citation statements)

References 122 publications

Supporting

Mentioning

110

Contrasting

Order By: Relevance

“…Lower Ct values have been shown to be associated with higher lactate dehydrogenase levels. Moreover, the severe COVID-19 cases with lower Ct scores have been shown to have low lymphocyte and Tcells counts; the total and differential neutrophil counts were however observed to be significantly increased [11].…”

Section: Biochemical/hematological Parametersmentioning

confidence: 95%

Correlation of Viral Load With the Clinical and Biochemical Profiles of COVID-19 Patients

Atique¹,

Ghafoor

Javed³

et al. 2021

Cureus

View full text Add to dashboard Cite

Background/objectiveCoronavirus infectious disease (COVID-19) is a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Some studies have shown that disease severity according to clinical and biochemical parameters are in direct relation to viral load while others have found no direct correlation. In this study, the COVID-19 cycle threshold (Ct) value, which is taken as a direct indicator of the viral load, has been correlated with the biochemical and clinical parameters in COVID-19 patients. MethodsIn this cross-sectional, retrospective, and single-center study, 365 patients admitted with COVID 19 were divided into three groups according to their Ct values obtained from reverse transcription-polymerase chain reaction RT-PCR as 1 (9-20), 2 (21-30), and 3 (31-40). The correlation of the COVID-19 Ct value with biochemical parameters and clinical presentation (taken as mild, moderate, and severe) was done and analyzed. The chi-square test was used for the correlation and calculated by using SPSS V-24.0 (IBM Corp., Armonk, NY). p-value <0.05 was considered significant statistically. ResultsDisease severity levels (mild, moderate, and severe) correlated in group 1 (Ct value 9 to 20), 2 (Ct value 21 to 30), and 3 (Ct value 31 to 40) but no significance was found between disease severity levels and the Ct value groups' p-value (>0.05). All the biochemical parameters analyzed (alanine transaminase (ALT), aspartate aminotransferase (AST), albumin, bilirubin, c-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, D-dimer, and total leucocyte count (TLC)) showed a significant p-value (<0.05) in all the three groups studied. Procalcitonin (PCT), however, did not show any significant value in any of the groups studied.In the intergroup assessment, it was found that the values of ALT, AST, albumin, CRP, ferritin, bilirubin, and TLC are maximum in group 2 with a downward trend in groups 1 and 2. Neutrophils and lymphocytes did not show any variations. LDH did not follow the trend of increasing viral load. ConclusionsThe severity of the disease was not statistically significant in the Ct value groups (p> 0.05). However biochemical parameters, i.e. ALT, AST, ALP, CRP, and bilirubin were statistically significant (p<0.05).Patients with COVID-19 should be closely monitored for the assessment of disease progression according to the above-mentioned biochemical parameters.

show abstract

Section: Biochemical/hematological Parametersmentioning

confidence: 95%

Correlation of Viral Load With the Clinical and Biochemical Profiles of COVID-19 Patients

Atique¹,

Ghafoor

Javed³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…As discussed above, those with negative RT-PCR results, at least in part, should show false-negative laboratory results, as most of our patients were tested after 6 days of symptoms; hence, RT-PCR is prone to lose its sensitivity (4). There is no single answer as to why patients with positive RT-PCR results show worse outcomes, while some insights from recent literature (31) demonstrate that, in patients with critical and severe COVID-19, the viral load was higher, which translated more often into persistent positive RT-PCR results. As the viral load was not quantified in our study, this might be a possible indirect inference of a higher viral load.…”

Section: ' Discussionmentioning

confidence: 99%

Lung Lesion Burden found on Chest CT as a Prognostic Marker in Hospitalized Patients with High Clinical Suspicion of COVID-19 Pneumonia: a Brazilian experience

Fonseca¹,

Júnior²,

Araújo-Filho³

et al. 2021

Clinics

View full text Add to dashboard Cite

To investigate the relationship between lung lesion burden (LLB) found on chest computed tomography (CT) and 30-day mortality in hospitalized patients with high clinical suspicion of coronavirus disease 2019 (COVID-19), accounting for tomographic dynamic changes. METHODS: Patients hospitalized with high clinical suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a dedicated and reference hospital for COVID-19, having undergone at least one RT-PCR test, regardless of the result, and with one CT compatible with COVID-19, were retrospectively studied. Clinical and laboratory data upon admission were assessed, and LLB found on CT was semi-quantitatively evaluated through visual analysis. The primary outcome was 30-day mortality after admission. Secondary outcomes, including the intensive care unit (ICU) admission, mechanical ventilation used, and length of stay (LOS), were assessed. RESULTS: A total of 457 patients with a mean age of 57±15 years were included. Among these, 58% presented with positive RT-PCR result for COVID-19. The median time from symptom onset to RT-PCR was 8 days [interquartile range 6-11 days]. An initial LLB of X50% using CT was found in 201 patients (44%), which was associated with an increased crude at 30-day mortality (31% vs. 15% in patients with LLB of o50%, po0.001). An LLB of X50% was also associated with an increase in the ICU admission, the need for mechanical ventilation, and a prolonged LOS after adjusting for baseline covariates and accounting for the CT findings as a time-varying covariate; hence, patients with an LLB of X50% remained at a higher risk at 30-day mortality (adjusted hazard ratio 2.17, 95% confidence interval 1.47-3.18, po0.001). CONCLUSION: Even after accounting for dynamic CT changes in patients with both clinical and imaging findings consistent with COVID-19, an LLB of X50% might be associated with a higher risk of mortality.

show abstract

“…S gene target failure (SGTF) was identified in three specimens. The CT values of gene targets amplified in the TaqPath assay were CT 31 and below indicating, high to medium viral loads of SARS-CoV-2 [ 11 ].…”

Section: Main Textmentioning

confidence: 99%

Discrepancy between PCR based SARS-CoV-2 tests suggests the need to re-evaluate diagnostic assays

et al. 2021

View full text Add to dashboard Cite

Objective We investigated the discrepancy between clinical and PCR-based diagnosis of COVID-19. We compared results of ten patients with mild to severe COVID-19. Respiratory samples from all cases were tested on the Roche SARS-CoV-2 (Cobas) assay, Filmarray RP2.1 (bioMereiux) and TaqPath™ COVID19 (Thermofisher) PCR assays. Results Laboratory records of ten patients with mild to severe COVID-19 were examined. Initially, respiratory samples from the patients were tested as negative on the SARS-CoV-2 Roche® assay. Further investigation using the BIOFIRE® Filmarray RP2.1 assay identified SARS-CoV-2 as the pathogen in all ten cases. To investigate possible discrepancies between PCR assays, additional testing was conducted using the TaqPath™ COVID19 PCR. Eight of ten samples were positive for SARS-CoV-2 on the TaqPath assay. Further, Spike gene target failures (SGTF) were identified in three of these eight cases. Discrepancy between the three PCR assays could be due to variation in PCR efficiencies of the amplification reactions or, variation at primer binding sites. Strains with SGTF indicate the presence of new SARS-CoV-2 variant strains. Regular modification of gene targets in diagnostic assays may be necessary to maintain robustness and accuracy of SARS-CoV-2 diagnostic assays to avoid reduced case detection, under-surveillance, and missed opportunities for control.

show abstract

Viral Dynamics and Real-Time RT-PCR Ct Values Correlation with Disease Severity in COVID-19

Cited by 171 publications

References 122 publications

Correlation of Viral Load With the Clinical and Biochemical Profiles of COVID-19 Patients

Correlation of Viral Load With the Clinical and Biochemical Profiles of COVID-19 Patients

Lung Lesion Burden found on Chest CT as a Prognostic Marker in Hospitalized Patients with High Clinical Suspicion of COVID-19 Pneumonia: a Brazilian experience

Discrepancy between PCR based SARS-CoV-2 tests suggests the need to re-evaluate diagnostic assays

Contact Info

Product

Resources

About