Cycle Threshold Values in the Context of Multiple RT-PCR Testing for SARS-CoV-2
| Autor: | Daniel Garzon-Chavez, Juan Miguel Galarza, Daniel Romero-Alvarez, Jorge Reyes, Francisco Mora, Cristina Albán, Edison Ligña, Emilia Espin, Franklin Espinosa, Enrique Teran |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) Hospitalized patients diagnosis Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Short Report coronavirus RT-PCR Context (language use) 03 medical and health sciences 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine Risk Management and Healthcare Policy Cycle threshold business.industry SARS-CoV-2 030503 health policy & services Health Policy pandemic Public Health Environmental and Occupational Health COVID-19 cycle thresholds Real-time polymerase chain reaction Turnover time Cohort 0305 other medical science business |
| Zdroj: | Risk Management and Healthcare Policy |
| ISSN: | 1179-1594 |
| Popis: | Purpose Discharge or follow up of confirmed coronavirus disease 2019 (COVID-19) cases depend on accurate interpretation of RT-PCR. Currently, positive/negative interpretations are based on amplification instead of quantification of cycle threshold (Ct) values, which could be used as proxies of patient infectiousness. Here, we measured Ct values in hospitalized confirmed COVID-19 patients at different times and its implications in diagnosis and follow up. Patients and Methods Observational study between March 17th-May 12th, 2020 using multiple RT-PCR testing. A cohort of 118 Hispanic hospitalized patients with confirmed COVID-19 diagnosis in a reference hospital in Quito, Ecuador. Multiple RT-PCR tests were performed using deep nasal swab samples and the assessment of SARS-CoV-2 genes N, RdRP, and E. Results Patients’ median age was of 49 years (range: 24–91) with a male majority (62.7%). We found increasing levels of Ct values in time, with a mean Ct value of 29.13 (n = 61, standard deviation (sd) = 5.55) for the first test and 34.38 (n = 60, sd = 4), 35.52 (n = 20, sd = 2.85), and 36.12 (n = 6, sd = 3.28), for the second, third, and fourth tests, respectively. Time to RT-PCR lack of amplification for all tests was of 34 days while time to RT-PCR Ct values >33 was of 30 days. Conclusion Cycle thresholds can potentially be used to improve diagnosis, management and control. We found that turnover time for negativity can be large for hospitalized patients and that 11% cases persisted with infectious Ct values for more time than the current isolation recommendations. Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/KjdapC4SGeE |
| Databáze: | OpenAIRE |
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