tetano
Editor, Senior Moderator
Infez Med
. 2021 Sep 10;29(3):386-392.
doi: 10.53854/liim-2903-9. eCollection 2021.
Can a quantitative assessment of SARS-CoV-2 PCR predict degree of severity and outcomes in critical care patients with COVID-19?
Rosalind Stonham[SUP] 1 [/SUP], Chantelle Monck[SUP] 2 [/SUP], Laurence Orchard[SUP] 1 [/SUP], Laurence Baker[SUP] 1 [/SUP], Nusreen Ahmad-Saeed[SUP] 2 [/SUP], Simon Friar[SUP] 2 [/SUP], Buddhini Samaraweera[SUP] 2 3 [/SUP], Adhyana Mahanama[SUP] 2 3 [/SUP], Emanuela Pelosi[SUP] 2 4 [/SUP], Eleri Wilson-Davies[SUP] 2 [/SUP], Ahilanandan Dushianthan[SUP] 1 4 5 [/SUP], Kordo Saeed[SUP] 4 6 [/SUP]
Affiliations
Abstract
Real-Time polymerase chain reaction (qPCR) is the gold standard diagnostic method for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cycle threshold (Ct) is defined as the number of heating and cooling cycles required during the PCR process. Ct-values are inversely proportional to the amount of target nucleic acid in a sample. Our aim, in this retrospective study, was to determine the impact of serial SARS-CoV-2 qPCR Ct-values on: mortality, need for mechanical ventilation (MV) and development of acute kidney injury (AKI) in patients admitted to the intensive care unit (ICU) with COVID-19. Ct values were evaluated during the time points from pre-ICU admission to week 1, week 2 and week 3 during ICU stay; impact on mortality, need for MV and AKI was determined. There was a continuous increment in Ct-values over the ICU stay from 1[SUP]st[/SUP] week through to 3[SUP]rd[/SUP] week. Although not significant, lower ICU 1[SUP]st[/SUP] week Ct-values were associated with Black ethnicity, increased need for MV and mortality. However, patients who had developed AKI at any stage of their illness had significantly lower Ct-values compared to those with normal renal function. When ICU 1[SUP]st[/SUP]-week Ct-values are subcategorised as <20, 20-30 and >30 the 28-day survival probability was less for patients with Ct-values of <20. This report shows that the impact of Ct-values and outcomes, especially AKI, among patients at different time points prior to and during ICU stay, larger studies are required to confirm out findings.
Keywords: COVID-19; Ct values PCR; SARS-CoV-2; intensive care; qPCR.
. 2021 Sep 10;29(3):386-392.
doi: 10.53854/liim-2903-9. eCollection 2021.
Can a quantitative assessment of SARS-CoV-2 PCR predict degree of severity and outcomes in critical care patients with COVID-19?
Rosalind Stonham[SUP] 1 [/SUP], Chantelle Monck[SUP] 2 [/SUP], Laurence Orchard[SUP] 1 [/SUP], Laurence Baker[SUP] 1 [/SUP], Nusreen Ahmad-Saeed[SUP] 2 [/SUP], Simon Friar[SUP] 2 [/SUP], Buddhini Samaraweera[SUP] 2 3 [/SUP], Adhyana Mahanama[SUP] 2 3 [/SUP], Emanuela Pelosi[SUP] 2 4 [/SUP], Eleri Wilson-Davies[SUP] 2 [/SUP], Ahilanandan Dushianthan[SUP] 1 4 5 [/SUP], Kordo Saeed[SUP] 4 6 [/SUP]
Affiliations
- PMID: 35146343
- PMCID: PMC8805500
- DOI: 10.53854/liim-2903-9
Abstract
Real-Time polymerase chain reaction (qPCR) is the gold standard diagnostic method for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cycle threshold (Ct) is defined as the number of heating and cooling cycles required during the PCR process. Ct-values are inversely proportional to the amount of target nucleic acid in a sample. Our aim, in this retrospective study, was to determine the impact of serial SARS-CoV-2 qPCR Ct-values on: mortality, need for mechanical ventilation (MV) and development of acute kidney injury (AKI) in patients admitted to the intensive care unit (ICU) with COVID-19. Ct values were evaluated during the time points from pre-ICU admission to week 1, week 2 and week 3 during ICU stay; impact on mortality, need for MV and AKI was determined. There was a continuous increment in Ct-values over the ICU stay from 1[SUP]st[/SUP] week through to 3[SUP]rd[/SUP] week. Although not significant, lower ICU 1[SUP]st[/SUP] week Ct-values were associated with Black ethnicity, increased need for MV and mortality. However, patients who had developed AKI at any stage of their illness had significantly lower Ct-values compared to those with normal renal function. When ICU 1[SUP]st[/SUP]-week Ct-values are subcategorised as <20, 20-30 and >30 the 28-day survival probability was less for patients with Ct-values of <20. This report shows that the impact of Ct-values and outcomes, especially AKI, among patients at different time points prior to and during ICU stay, larger studies are required to confirm out findings.
Keywords: COVID-19; Ct values PCR; SARS-CoV-2; intensive care; qPCR.