Open AccessCan a quantitative assessment of SARS-CoV-2 PCR predict degree of severity and outcomes in critical care patients with COVID-19?
Author(s) -
Rosalind Stonham,
Chantelle Monck,
Laurence Orchard,
Laurence H. Baker,
Nusreen Ahmad-Saeed,
Simon Friar,
Buddhini Samaraweera,
Adhyana I. K. Mahanama,
Emanuela Pelosi,
Eleri Wilson-Davies,
Ahilanandan Dushianthan,
Kordo Saeed
Publication year - 2021
Publication title -
le infezioni in medicina
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.395
H-Index - 22
eISSN - 2532-8689
pISSN - 1124-9390
DOI - 10.53854/liim-2903-9
Subject(s) - medicine , intensive care unit , mechanical ventilation , acute kidney injury , covid-19 , retrospective cohort study , gold standard (test) , intensive care , apache ii , emergency medicine , severity of illness , intensive care medicine , disease , infectious disease (medical specialty)
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 st week through to 3 rd week. Although not significant, lower ICU 1 st 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 st -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.