SARS-CoV-2'nin Rt-PCR Döngüsü Eşik Değerlerinin ve COVID-19 hastalarının epidemiyolojik verilerinin değerlendirilmesi
Abstract
Giriş: COVID-19 enfeksiyonu, RT-PCR ile teşhis edilmektedir. Döngü eşiği (Ct) değerlerine göre yorumlanan bu test sonuçları viral yükün indirekt ölçümlerini sağlar. Bu çalışmada hastaların demografik özellikleri ve semptomları ile Ct değerleri arasındaki ilişkiyi değerlendirmeyi amaçladık.
Gereç ve Yöntemler: COVID-19 şüphesi olan hastaların nazofaringeal sürüntüleri toplandı ve SARS-CoV-2 için RT-PCR ile test edildi. RT-PCR ile COVID-19 tanısı alan hastaların demografik bilgileri, tıbbi öyküleri, maruziyet zaman çizelgeleri ve semptomları hastane bilgi sisteminden elde edildi.
Bulgular: Toplam 619 hasta sonucu çalışmaya dahil edildi. Ct değerleri 18> yaş için 24,74 (20,95-27,64) ve 22,85 (20,14-26,22) ≥18 yaş olarak belirlendi, Ct değerleri arasında yaşa göre istatistiksel olarak fark yoktu. Hipertansiyon, COVID-19 hastalarında en sık görülen yandaş hastalık (%13,3) oldu. Semptomların başlangıcı ile Ct değerleri arasında pozitif bir korelasyon saptandı, Ct değerleri semptom başlangıcından hemen sonra en düşüktü (daha yüksek bir viral RNA konsantrasyonuna karşılık gelir). Ateş, baş ağrısı, kas-eklem ağrısı olan hastalarda Ct değerleri, bu semptomları olmayan hastalara göre anlamlı olarak daha düşüktü.
Sonuç: Solunum yolu semptomları olan kişilerde SARS-CoV-2 için erken test yapılması, viral yük ve bulaşma hızlarının yüksek olduğu zamanlarda izole edilmesi önemlidir.
Keywords
References
- 1. Tay MZ, Poh CM, Rénia L et al. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Imm 2020; 20: 363-374. doi.org/10.1038/s41577-020-0311-8.
- 2. Zhou P, Yang XL, Wang XGet al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579: 270-273. doi: 10.1038/s41586- 020-2012-7.
- 3. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-1062. doi: 10.1016/S0140-6736(20)30566-3
- 4. https://covid19.who.int/ (Accessed: 13/07/2023)
- 5. Tang Y-W, Schmitz JE, Persing DH et al.. Laboratory diagnosis of COVID-19: current issuesand challenges. J Clin Microbiol 2020;58:e00512–e520. doi.org/10.1128/JCM.00512-20.
- 6. Bustin SA, Mueller R. Real-time reverse transcription PCR (qRT-PCR) and its potential use in clinical diagnosis. Clin Sci 2005;109:365–379. doi.org/10.1042/CS20050086
- 7. Rao SN, Manissero D, Steele VR et al. A Narrative Systematic Review of the Clinical Utility of Cycle Threshold Values in the Context of COVID-19. Infect Dis Ther 2020; 9i:573–586. doi.org/10.1007/s40121-020-00324-3.
- 8. Tom MR, Mina MJ. To interpret the SARS-CoV-2 test, consider the cycle threshold value. Clin Infect Dis 2020; 71, 2252–2254. doi.org/10.1093/cid/ciaa619.
- 9. Salvatore PP, Dawson P, Wadhwa A, et al. Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020;72:e761-e767. doi.org/10.1093/cid/ciaa1469.
- 10. Singanayagam A, Patel M, Charlett A, et al. Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020. Euro Surveill 2020;25(32):pii=2001483. doi.org/10.2807/1560-7917.ES.2020.25.32.2001483
- 11. Buchan BW, Hoff JS, Gmehlin CG et al.. Distribution of SARS-CoV-2 PCR Cycle Threshold Values Provide Practical Insight Into Overall and Target-Specific Sensitivity Among Symptomatic Patients. Am J Clin Pathol 2020;154:479-485. doi.org/10.1093/ajcp/aqaa133.
- 12. Heald-Sargent T, Muller WJ, Zheng X, et al. Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in PatientsWith Mild to Moderate Coronavirus Disease 2019 (COVID-19). JAMA Pediatrics 2020; 174:902-903. doi:10.1001/jamapediatrics.2020.3651
- 13. Wölfel R, CormanVM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020;581:465-470. doi.org/10.1038/s41586-020-2196-x
- 14. Zheng S, Fan J, Yu F, et al. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. BMJ 2020;369, m1443. doi: 10.1136/bmj.m1443.
- 15. Yang J, Zheng Y, Gou X et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Inf Dis 2020;94: 91-95. doi.org/10.1016/j.ijid.2020.03.017
- 16. Lan F-Y, Filler R, Mathew S, et al. COVID-19 symptoms predictive of healthcare workers’ SARSCoV- 2 PCR results. PLoS ONE 2020; 15(6): e0235460. doi.org/10.1371/journal.pone.0235460.
- 17. Allen WE, Altae-Tran H, Briggs, et al. Population-scale longitudinal mapping of COVID-19 symptoms, behaviour and testing. Nat Hum Behav, 2020;4: 972–982. doi.org/10.1038/s41562-020-00944-2.
- 18. Struyf T, Deeks JJ, Dinnes J, et al. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19. Coch Database Syst Rev 2021; 2. Art. No.: CD013665.doi: 10.1002/14651858.CD013705.
- 19. Menni C, Sudre CH, Steves CJ, et al. Quantifying additional COVID-19 symptoms will save lives. Lancet 2020; 395: e107-e108. doi.org/10.1016/S0140-6736(20)31281-2.
- 20. Wang B, Li R, Lu Z, et al. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging 2020;12: 6049-6057. 10.18632/aging.103000
- 21. Azzi L, Carcano G, Gianfagna F, et al. Saliva is a reliable tool to detect SARS-CoV-2. J Infect 2020;81: e45–e50. doi.org/10.1016/j.jinf.2020.04.005.
- 22. Arons MM, Hatfield KM, Reddy SC, et al. Presymptomatic SARS-CoV-2 Infections and Transmissionin a Skilled Nursing Facility. N Engl J Med 2020; 382:2081-2090. doi: 10.1056/NEJMoa2008457.
- 23. Young BE, On SWX, Kalimuddin S et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA 2020;323:1488-1494. doi:10.1001/jama.2020.3204.
- 24. He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med 2020; 26: 672–675. doi.org/10.1038/s41591-020-0869-5.
- 25. Yuwono Soeroto A, Antartika R, Nauli Asriputri N, et al. Real-time RT-PCR Ct value is not associated with COVID-19 disease severity: an observational study in tertiary COVID-19 referral hospital of West Java, Indonesia. Eur Rev Med Pharmacol Sci 2022; 26: 4893-4901.
- 26. Kurzeder L, Jörres RA, Unterweger T, et al. A simple risk score for mortality including the PCR Ct value upon admission in patients hospitalized due to COVID-19. Infection 2022; 50: 1155–1163.
Evaluation of Rt-PCR Cycle Threshold Values of SARS-CoV-2 and epidemiological datas of COVID-19 patients
Abstract
Introduction: COVID-19 infection is diagnosed by RT-PCR. In this test results interpreted according to the cycle threshold (Ct) values, provide indirect measurements of viral load. In this study we aimed to the evalaute the relationship between Ct values and demographics and sypmtoms of patients.
Material and Methods: The nasopharyngeal swab of the patients suspected with COVID-19 were collected and tested by RT-PCR for SARS-CoV-2. Demographics, medical history, timelines for exposure and symptoms of the patients diagnosed as COVID-19 by RT-PCRwere obtained from the hospital information system.
Results: Total of 619 patient result was enrolled in the study. Ct values were determined as 24.74 (20.95-27.64) for 18> years-old and 22.85 (20.14-26.22) ≥18 years-old, there was no statistically difference according to the age among Ct values. Hypertension was the most common comorbid disease (13.3%) among COVID-19 patients. A positive correlation was detected among the onset of the symptoms and Ct values, Ct values were lowest (corresponding to a higher viral RNA concentration) soon after symptom onset. Patients who had fever, headache, muscle-joint pain significantly had lower Ct values were than patients who did not have these sypmtoms.
Conclusion: It is important to early testing for SARS-CoV-2 among persons who have respiratory symptoms, and isolation of them when their viral load and transmission rate is higher.
References
- 1. Tay MZ, Poh CM, Rénia L et al. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Imm 2020; 20: 363-374. doi.org/10.1038/s41577-020-0311-8.
- 2. Zhou P, Yang XL, Wang XGet al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579: 270-273. doi: 10.1038/s41586- 020-2012-7.
- 3. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-1062. doi: 10.1016/S0140-6736(20)30566-3
- 4. https://covid19.who.int/ (Accessed: 13/07/2023)
- 5. Tang Y-W, Schmitz JE, Persing DH et al.. Laboratory diagnosis of COVID-19: current issuesand challenges. J Clin Microbiol 2020;58:e00512–e520. doi.org/10.1128/JCM.00512-20.
- 6. Bustin SA, Mueller R. Real-time reverse transcription PCR (qRT-PCR) and its potential use in clinical diagnosis. Clin Sci 2005;109:365–379. doi.org/10.1042/CS20050086
- 7. Rao SN, Manissero D, Steele VR et al. A Narrative Systematic Review of the Clinical Utility of Cycle Threshold Values in the Context of COVID-19. Infect Dis Ther 2020; 9i:573–586. doi.org/10.1007/s40121-020-00324-3.
- 8. Tom MR, Mina MJ. To interpret the SARS-CoV-2 test, consider the cycle threshold value. Clin Infect Dis 2020; 71, 2252–2254. doi.org/10.1093/cid/ciaa619.
- 9. Salvatore PP, Dawson P, Wadhwa A, et al. Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020;72:e761-e767. doi.org/10.1093/cid/ciaa1469.
- 10. Singanayagam A, Patel M, Charlett A, et al. Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020. Euro Surveill 2020;25(32):pii=2001483. doi.org/10.2807/1560-7917.ES.2020.25.32.2001483
- 11. Buchan BW, Hoff JS, Gmehlin CG et al.. Distribution of SARS-CoV-2 PCR Cycle Threshold Values Provide Practical Insight Into Overall and Target-Specific Sensitivity Among Symptomatic Patients. Am J Clin Pathol 2020;154:479-485. doi.org/10.1093/ajcp/aqaa133.
- 12. Heald-Sargent T, Muller WJ, Zheng X, et al. Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in PatientsWith Mild to Moderate Coronavirus Disease 2019 (COVID-19). JAMA Pediatrics 2020; 174:902-903. doi:10.1001/jamapediatrics.2020.3651
- 13. Wölfel R, CormanVM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020;581:465-470. doi.org/10.1038/s41586-020-2196-x
- 14. Zheng S, Fan J, Yu F, et al. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. BMJ 2020;369, m1443. doi: 10.1136/bmj.m1443.
- 15. Yang J, Zheng Y, Gou X et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Inf Dis 2020;94: 91-95. doi.org/10.1016/j.ijid.2020.03.017
- 16. Lan F-Y, Filler R, Mathew S, et al. COVID-19 symptoms predictive of healthcare workers’ SARSCoV- 2 PCR results. PLoS ONE 2020; 15(6): e0235460. doi.org/10.1371/journal.pone.0235460.
- 17. Allen WE, Altae-Tran H, Briggs, et al. Population-scale longitudinal mapping of COVID-19 symptoms, behaviour and testing. Nat Hum Behav, 2020;4: 972–982. doi.org/10.1038/s41562-020-00944-2.
- 18. Struyf T, Deeks JJ, Dinnes J, et al. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19. Coch Database Syst Rev 2021; 2. Art. No.: CD013665.doi: 10.1002/14651858.CD013705.
- 19. Menni C, Sudre CH, Steves CJ, et al. Quantifying additional COVID-19 symptoms will save lives. Lancet 2020; 395: e107-e108. doi.org/10.1016/S0140-6736(20)31281-2.
- 20. Wang B, Li R, Lu Z, et al. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging 2020;12: 6049-6057. 10.18632/aging.103000
- 21. Azzi L, Carcano G, Gianfagna F, et al. Saliva is a reliable tool to detect SARS-CoV-2. J Infect 2020;81: e45–e50. doi.org/10.1016/j.jinf.2020.04.005.
- 22. Arons MM, Hatfield KM, Reddy SC, et al. Presymptomatic SARS-CoV-2 Infections and Transmissionin a Skilled Nursing Facility. N Engl J Med 2020; 382:2081-2090. doi: 10.1056/NEJMoa2008457.
- 23. Young BE, On SWX, Kalimuddin S et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA 2020;323:1488-1494. doi:10.1001/jama.2020.3204.
- 24. He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med 2020; 26: 672–675. doi.org/10.1038/s41591-020-0869-5.
- 25. Yuwono Soeroto A, Antartika R, Nauli Asriputri N, et al. Real-time RT-PCR Ct value is not associated with COVID-19 disease severity: an observational study in tertiary COVID-19 referral hospital of West Java, Indonesia. Eur Rev Med Pharmacol Sci 2022; 26: 4893-4901.
- 26. Kurzeder L, Jörres RA, Unterweger T, et al. A simple risk score for mortality including the PCR Ct value upon admission in patients hospitalized due to COVID-19. Infection 2022; 50: 1155–1163.
Details
| Primary Language | English |
|---|---|
| Subjects | Virology |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | September 3, 2023 |
| Publication Date | August 30, 2023 |
| Acceptance Date | July 17, 2023 |
| Published in Issue | Year 2023 Volume: 7 Issue: 2 |
Cite
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