Abstract
Background. SARS-CoV-2 viral loads may aid in the risk stratification of patients with COVID-19. Methods. 486 patients tested positive for SARS Cov2 by real time RT-PCR were included in this study. All the tests were performed on nasopharyngeal swabs during the first week after symptom onset using Sansure Biotech™ SARS Cov2 real time RT-PCR kits. Patient’s condition was monitored over a period of one month after the onset of symptoms. Results. The mean Ct value in the group of patients who developed acute respiratory distress syndrome (ARDS +) was 18.27 (95% CI: 17.43-19.10) while for the ARDSgroup it was 33.06 (95% CI: 32.77-33.34). Discussion. The Ct values in the group of patients who developed ARDS (ARDS +) were significantly lower than those observed in the ARDS- group. By setting a cut-off value, the determination Ct values (on a qualitative technique) from nasopharyngeal swabs performed during the first week after symptom onset will assist clinicians in risk-stratifying patients. Conclusion. Our data show that the determination of SARS CoV2 RTPCR cycle threshold values from nasopharyngeal swabs performed during the first week after symptom onset may aid in the risk stratification of patients with COVID-19
Highlights
Risk stratification in COVID-19 remains a challenge, in prior analyses of the SARS-CoV-1 outbreak, viral load within the nasopharynx was associated with poor disease outcome [1,2]
The average of cycle threshold (Ct) value in the Acute respiratory destress syndrome (ARDS) group was 18,27 ranging from 13,01 to 24,66, on the other hand the average of Ct value in the asymptomatic to moderate forms group was 33,06 ranging from 20,29 to 37,29
The association between SARS CoV2 viral load and the poor disease outcome was proven by some studies [3,4,5], but the quantitative SARS CoV2 RT-PCR techniques are less available and more expensive, on the other hand, in some studies Ct values were used as an approximation of viral loads [13,14,15], the aim of the current study is to find out if such approximation can be used in risk stratification of patients with COVID-19, so we conducted an analysis of Ct values and disease progression in 486 patients
Summary
Risk stratification in COVID-19 remains a challenge, in prior analyses of the SARS-CoV-1 outbreak, viral load within the nasopharynx was associated with poor disease outcome [1,2]. SARS-CoV-2 viral loads may aid in the risk stratification of patients with COVID-19. 486 patients tested positive for SARS Cov by real time RT-PCR were included in this study. All the tests were performed on nasopharyngeal swabs during the first week after symptom onset using Sansure BiotechTM SARS Cov real time RT-PCR kits. By setting a cut-off value, the determination Ct values (on a qualitative technique) from nasopharyngeal swabs performed during the first week after symptom onset will assist clinicians in risk-stratifying patients. Our data show that the determination of SARS CoV2 RTPCR cycle threshold values from nasopharyngeal swabs performed during the first week after symptom onset may aid in the risk stratification of patients with COVID-19
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