Association of SARS-CoV-2 cycle threshold (Ct) values with clinical course and serum biomarkers in COVID-19 patients

Authors

  • Imran Saglik Department of Medical Microbiology, Bursa Uludag University, Bursa, Turkey https://orcid.org/0000-0003-0864-4989
  • Beyza Ener Department of Medical Microbiology, Bursa Uludag University, Bursa, Turkey https://orcid.org/0000-0002-4803-8206
  • Halis Akalin Department of Infectious Diseases and Clinical Microbiology, Bursa Uludag University, Bursa, Turkey https://orcid.org/0000-0001-7530-1279
  • Buşra Ozdemir Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
  • Gokhan Ocakoglu Department of Biostatistics, Bursa Uludag University, Bursa, Turkey
  • Baris Yalcin Microbiology Laboratory of Public Health, Bursa, Turkey
  • Ugur Onal Department of Infectious Diseases and Clinical Microbiology, Bursa Uludag University, Bursa, Turkey
  • Ozge Aydin Guçlu Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey
  • Nilufer Aylin Acet Ozturk Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey
  • Ulku Tuzemen Department of Medical Microbiology, Bursa Uludag University, Bursa, Turkey
  • Ezgi Demirdogen Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey
  • Asli Gorek Dilektasli Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey
  • Harun Agca Department of Medical Microbiology, Bursa Uludag University, Bursa, Turkey
  • Esra Kazak Department of Infectious Diseases and Clinical Microbiology, Bursa Uludag University, Bursa, Turkey
  • Funda Coskun Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey
  • Yasemin Heper Department of Infectious Diseases and Clinical Microbiology, Bursa Uludag University, Bursa, Turkey
  • Melda Payaslioglu Department of Medical Microbiology, Bursa Uludag University, Bursa, Turkey
  • Dane Ediger Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey
  • Ahmet Ursavas Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey https://orcid.org/0000-0003-4482-5904
  • Emel Yilmaz Department of Infectious Diseases and Clinical Microbiology, Bursa Uludag University, Bursa, Turkey
  • Cuneyt Ozakin Department of Medical Microbiology, Bursa Uludag University, Bursa, Turkey
  • Esra Uzaslan Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey
  • Mehmet Karadag Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey https://orcid.org/0000-0002-9027-1132

DOI:

https://doi.org/10.3855/jidc.15818

Keywords:

COVID-19, SARS-CoV-2, Ct value, severity, lymphocyte

Abstract

Introduction: Our knowledge has gaps regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication levels and its association to severity of Coronavirus disease 2019 (COVID-19). The aim of this study was to investigate the association of SARS-CoV-2 viral load with disease severity and serum biomarkers in COVID-19 patients.

Methodology: Viral load was determined via cycle threshold (Ct) values of SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in 214 adult patients. Ct values were compared with clinical severity, biochemical and hematological biomarkers.

Results: Clinical course of the disease was mild (49.1%), moderate (40.2%), and severe (10.7%). Median Ct value was 28.2 (IQR: 22.2–33.8) during the first week of the disease. Ct values were lower within five days after symptom onset [lowest Ct value on the third day (median: 24, IQR: 20.6–32.3)], but they increased significantly during the second and third weeks. No association was detected between admission Ct values and disease severity. Gender, age, co-morbidity, and mortality did not differ significantly in patients with low (≤ 25) and high (> 25) Ct values. White blood cell, neutrophil, platelet, and especially lymphocyte counts, were significantly lower in patients with low Ct values.

Conclusions: No definitive/clear correlation between SARS-CoV-2 viral load and severity and mortality was found in the studied COVID-19 patients. However, neutrophil, platelet, and especially lymphocyte count were significantly lower in patients with a high viral load.

Author Biographies

Imran Saglik, Department of Medical Microbiology, Bursa Uludag University, Bursa, Turkey

  1.  

Beyza Ener, Department of Medical Microbiology, Bursa Uludag University, Bursa, Turkey

  1. Bursa Uludag University Faculty of Medicine, Department Of Medical Microbiology

Halis Akalin, Department of Infectious Diseases and Clinical Microbiology, Bursa Uludag University, Bursa, Turkey

  1. Bursa Uludag University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology

Buşra Ozdemir, Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey

Canakkale Onsekiz Mart University, Department of Molecular Biology And Genetics

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Published

2022-03-31

How to Cite

1.
Saglik I, Ener B, Akalin H, Ozdemir B, Ocakoglu G, Yalcin B, Onal U, Aydin Guçlu O, Acet Ozturk NA, Tuzemen U, Demirdogen E, Gorek Dilektasli A, Agca H, Kazak E, Coskun F, Heper Y, Payaslioglu M, Ediger D, Ursavas A, Yilmaz E, Ozakin C, Uzaslan E, Karadag M (2022) Association of SARS-CoV-2 cycle threshold (Ct) values with clinical course and serum biomarkers in COVID-19 patients. J Infect Dev Ctries 16:445–452. doi: 10.3855/jidc.15818

Issue

Section

Coronavirus Pandemic

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