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

Abstract

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.

Intramuscular vs Intravenous SARS-CoV-2 Neutralizing Antibody Sotrovimab for Treatment of COVID-19 (COMET-TAIL): A Randomized Noninferiority Clinical Trial

“…Notably, 2 participants died in the 500-mg IM group vs no deaths in the 500-mg IV group. The increased rate of progression in the 250-mg IM group as compared with either of the 500-mg groups cannot be explained by differences in viral load, as AUC d1-8 values were similar across groups, consistent with findings that upper airway viral load is not an optimal biomarker for efficacy of SARS-CoV-2 treatments [ 1 , 25 , 26 ]. However, an exposure-response analysis suggested that serum concentrations on day 5 and day 8 were significant predictors of response.…”

Intramuscular Versus Intravenous SARS-CoV-2 Neutralizing Antibody Sotrovimab for Treatment of COVID-19 (COMET-TAIL): A Randomized Non-inferiority Clinical Trial

“…It is unknown whether the observed difference in deaths was due to chance or due to some other factor. Furthermore, the increased rate of progression in the 250-mg IM group compared with either of the 500-mg groups cannot be explained by differences in viral load, because the AUC d1-8 values were similar across the groups, consistent with findings that upper airway viral load is not an optimal biomarker for efficacy of SARS-CoV-2 treatments [1,20,21]. However, an exposure response analysis suggested that serum concentrations on day 5 and day 8 were significant predictors of response.…”

Evaluation of COVID-19 rapid antigen test against polymerase chain reaction test in immunocompromised patients

“…The World Health Organization (WHO) clearly stated that the Ct is inversely proportional to the viral load, which is also supported by our findings and other studies in the literature. And it’s also advised that another sample should be taken if the test results do not match the symptoms along with a new PCR [ 7 ]. Ciotti et al, tested 50 NPS, and concluded that the sensitivity of rapid antigen test was 30.77% and had 100% specificity, never the less, it was a significantly lower result than the sensitivity claimed by the manufacturer, this was explained by low Ct values, thus it is advised by WHO to use RAT with a sensitivity ≥80% and specificity ≥97% [ 8 ].…”