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Article

Diagnostic SARS-CoV-2 Cycle Threshold Value Predicts Disease Severity, Survival, and Six-Month Sequelae in COVID-19 Symptomatic Patients

1
Unit of Infectious Diseases, Department of Medical Sciences, University of Torino at the Amedeo di Savoia Hospital, Corso Svizzera 164, 10149 Torino, Italy
2
Microbiology and Molecular Biology Laboratory, Amedeo di Savoia Hospital, ASL Città di Torino, Corso Svizzera 164, 10149 Torino, Italy
3
Regional Department for Infectious Diseases and Emergency DIRMEI, ASL Città di Torino, Via S. Secondo 29, 10128 Torino, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Giorgio Palù
Received: 11 January 2021 / Revised: 8 February 2021 / Accepted: 9 February 2021 / Published: 11 February 2021
(This article belongs to the Section SARS-CoV-2 and COVID-19)
To date, there is no severe acute respiratory syndrome coronavirus 2-(SARS-CoV-2)-specific prognostic biomarker available. We assessed whether SARS-CoV-2 cycle threshold (Ct) value at diagnosis could predict novel CoronaVirus Disease 2019 (COVID-19) severity, clinical manifestations, and six-month sequelae. Hospitalized and outpatient cases were randomly sampled from the diagnoses of March 2020 and data collected at 6 months by interview and from the regional database for COVID-19 emergency. Patients were stratified according to their RNA-dependent-RNA-polymerase Ct in the nasopharyngeal swab at diagnosis as follows: Group A ≤ 20.0, 20.0 < group B ≤ 28.0, and Group C > 28.0. Disease severity was classified according to a composite scale evaluating hospital admission, worst oxygen support required, and survival. Two hundred patients were included, 27.5% in Groups A and B both, 45.0% in Group C; 90% of patients were symptomatic and 63.7% were hospitalized. The median time from COVID-19 onset to swab collection was five days. Lethality, disease severity, type, and number of signs and symptoms, as well as six-month sequelae distributed inversely among the groups with respect to SARS-CoV-2 Ct. After controlling for confounding, SARS-CoV-2 Ct at diagnosis was still associated with COVID-19-related death (p = 0.023), disease severity (p = 0.023), number of signs and symptoms (p < 0.01), and presence of six-month sequelae (p < 0.01). Early quantification of SARS-CoV-2 may be a useful predictive marker to inform differential strategies of clinical management and resource allocation. View Full-Text
Keywords: COVID-19; viral load; sequelae; outcomes; cycle threshold; severity; mortality; SARS-CoV-2 swab; predictive biomarker COVID-19; viral load; sequelae; outcomes; cycle threshold; severity; mortality; SARS-CoV-2 swab; predictive biomarker
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MDPI and ACS Style

Trunfio, M.; Venuti, F.; Alladio, F.; Longo, B.M.; Burdino, E.; Cerutti, F.; Ghisetti, V.; Bertucci, R.; Picco, C.; Bonora, S.; Di Perri, G.; Calcagno, A. Diagnostic SARS-CoV-2 Cycle Threshold Value Predicts Disease Severity, Survival, and Six-Month Sequelae in COVID-19 Symptomatic Patients. Viruses 2021, 13, 281. https://0-doi-org.brum.beds.ac.uk/10.3390/v13020281

AMA Style

Trunfio M, Venuti F, Alladio F, Longo BM, Burdino E, Cerutti F, Ghisetti V, Bertucci R, Picco C, Bonora S, Di Perri G, Calcagno A. Diagnostic SARS-CoV-2 Cycle Threshold Value Predicts Disease Severity, Survival, and Six-Month Sequelae in COVID-19 Symptomatic Patients. Viruses. 2021; 13(2):281. https://0-doi-org.brum.beds.ac.uk/10.3390/v13020281

Chicago/Turabian Style

Trunfio, Mattia; Venuti, Francesco; Alladio, Francesca; Longo, Bianca M.; Burdino, Elisa; Cerutti, Francesco; Ghisetti, Valeria; Bertucci, Roberto; Picco, Carlo; Bonora, Stefano; Di Perri, Giovanni; Calcagno, Andrea. 2021. "Diagnostic SARS-CoV-2 Cycle Threshold Value Predicts Disease Severity, Survival, and Six-Month Sequelae in COVID-19 Symptomatic Patients" Viruses 13, no. 2: 281. https://0-doi-org.brum.beds.ac.uk/10.3390/v13020281

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