The relationship between CT value and clinical outcomes in renal patients with COVID-19

Abstract

Purpose Concomitant kidney diseases raise the mortality rate due to the SARS-CoV-2 virus as an independent factor. Although a qualitative PCR test’s result is sufficient for diagnosis, Cycle threshold value may present relevant information to the physicians in providing faster treatment in patients with chronic conditions, including kidney diseases, to prevent morbidity and subsequent mortality. Thus, the present study was conducted to determine the relationship between the Cycle threshold value and clinical outcomes in renal patients with the coronavirus 2019. Methods This retrospective study was conducted on renal patients with the coronavirus 2019 infection admitted to Labbafinejad Hospital in Tehran, the capital of Iran, within a period of one year, from late February 2020 to February 2021. Data were collected per the prepared checklist. Cycle threshold values were measured by performing PCR on nasopharynx and oropharynx swab samples of patients. Results According to the adjusted analysis, having high viral load increased the odds of in-hospital mortality (aOR = 11.65, 95% CI 3.93–34.54), ICU admission (aOR = 5.49, 95% CI 2.16–13.97), and invasive ventilation (aOR = 7.18, 95% CI 2.61–19.74). Having high viral load also increased the odds of O 2 therapy (aOR = 3.08, 95% CI 0.79–12.01), although the difference was not statistically significant ( P = 0.105). Conclusion Cycle threshold value was a significant predictor of mortality in renal patients. Nevertheless, further studies are required on how to render optimal use of the Cycle threshold value, given that the quality of the test sample and the different groups of patients under study affect the effectiveness of this marker in predicting disease severity.

Investigation of Initial Viral Loads and Patient Characteristics as Predictors of COVID-19 Outcomes: A Retrospective Cohort Study

“…The initial viral loads were determined based on the Ct value of the SARS-CoV-2 RT-qPCR test from the nasopharyngeal swab taken at the time of the first laboratory-confirmed diagnosis. We selected the lowest Ct value among the targeted SARS-CoV-2 genes (RdRp, N gene, or E gene) and categorized the Ct values as either high (Ct ≤ 20) or low (Ct > 20), as previously described in earlier studies [16,17]. Age was divided into two groups: ≤60 years and >60 years.…”

“…The patient characteristics, stratified according to the high initial viral load (HIVL; Ct ≤ 20) and low initial viral load (LIVL; Ct > 20) groups, are summarized and compared in Table 1. The initial Ct values differed significantly between the two groups (HIVL: median [min-max], 16.66 [9.80-19.80] vs. LIVL: median [min-max], 27.02 [20.03-36.79]; p < 0.001). The proportion of unvaccinated patients was significantly higher in the LIVL group compared to the HIVL group (90.95% vs. 76.92%, p < 0.001).…”