Document Type : Original article
Authors
1 Mashhad University of Medical Sciences, Mashhad, Iran
2 Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
INTRODUCTION: there is no clear relationship between the threshold cycle of COVID-19 and severity of pulmonary involvement in the CT scan of patients.
Methods: 254 patients were included. The number of cycle of threshold virus, was extracted. The severity of pulmonary involvement was categorized based on the percentage of involvement of each lobe Based on CT scan. The relationship between the CT number and the involvement in the CT scan, was measured.
Results: 254 patients with COVID-19 such as 158 (62.2%) men and 96 (37.8%) women with a mean age and standard deviation of 17.785 ± 60.99 years. The average threshold cycle (CT Value) is 5.912 ± 19.38 and it’s minimum and maximum are 9 and 36.
The percentage of right lung involvement was 29.7±46.7% and the percentage of left lung involvement was 29.8±47.8%. The number of people without conflict is 6 (2.4) %, with mild conflict 39 (15.4) %, moderate 65 (25.6%) and severe 144 (56.7%). The number of people without involvement of the right lobe is 11 (4.3%), score 1, 42 (16.5%), score 2, 75 (29.5%), score 3, 51 (20.1%), involvement Score 4, 75 (29.5%).The number of people without left lobe involvement is 12 (4.7%), score 1, 46 (18.1%), score 2, 71 (28%), score 3, 48 (18.9%), involvement Score 4, 77 (30.3%) .
Conclusion: With the increase of lung involvement, the amount of threshold cycle has decreased, which can indicate the inverse relationship of threshold cycle with the severity of disease involvement.
Keywords
- Rao SN, Manissero D, Steele VR, Pareja J. A Systematic Review of the Clinical Utility of Cycle Threshold Values in the Context of COVID-19. Infect Dis Ther. 2020; 9(3):573-86. doi: 10.1007/s40121-020-00324-3 [PMid:32725536]
- Drosten C, Günther S, Preiser W, van der Werf S, Brodt HR, Becker S, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med. 2003;348(20):1967-76. doi:10.1056/NEJMoa030747 [PMid:12690091]
- Tom MR, Mina MJ. To Interpret the SARS-CoV-2 Test, Consider the Cycle Threshold Value. Clin Infect Dis. 2020;71(16):2252-4. doi: 10.1093/cid/ciaa619 [PMid:32435816]
- Alsharif W, Qurashi A. Effectiveness of COVID-19 diagnosis and management tools: A review. Radiography (Lond). 2021; 27(2):682-7. doi: 10.1016/j.radi.2020.09.010 [PMid:33008761]
- Basu A, Sheikh KH, Cuevas E, Sarkar R. COVID-19 detection from CT scans using a two-stage framework. Expert Systems with Applications.2022;193:116377. doi:0.1016/j.eswa.2021.116377 [PMid:35002099]
- Martínez Chamorro E, Díez Tascón A, Ibáñez Sanz L, Ossaba Vélez S, Borruel Nacenta S. Radiologic diagnosis of patients with COVID-19. Radiología (English Edition)
- Adibi A, Kazemi K, Hajiahmadi S, Shayganfar A, Abdollahpour I, Manteghinejad A, et al. The value of thoracic computed tomography scan comparing to reverse transcription-polymerase chain reaction for the diagnosis of COVID-19. J Res Med Sci. 2021; 26:117. doi:10.4103/jrms.JRMS_1187_20 [PMid:35126580]
- Santura I, Kawalec P, Furman M, Bochenek T. Chest computed tomography versus RT-PCR in early diagnostics of COVID-19 - a systematic review with meta-analysis. Pol J Radiol. 2021;86:e518-e31. doi:10.5114/pjr.2021.109074 [PMid:34820028]
- Kovács A, Palásti P, Veréb D, Bozsik B, Palkó A, Kincses ZT. The sensitivity and specificity of chest CT in the diagnosis of COVID-19. Eur Radiol. 2021; 31(5):2819-24. doi:10.1007/s00330-020-07347-x [PMid:33051732]
- Juanola-Falgarona M, Peñarrubia L, Jiménez-Guzmán S, Porco R, Congost-Teixidor C, Varo-Velázquez M, et al. Ct values as a diagnostic tool for monitoring SARS-CoV-2 viral load using the QIAstat-Dx® Respiratory SARS-CoV-2 Panel. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases. 2022; 122:930-5. doi: 10.1016/j.ijid.2022.07.022 [PMid:35840097]
- Hasegawa K, Jartti T, Mansbach JM, Laham FR, Jewell AM, Espinola JA, et al. Respiratory syncytial virus genomic load and disease severity among children hospitalized with bronchiolitis: multicenter cohort studies in the United States and Finland. J Infect Dis. 2015; 211(10):1550-9.doi:10.1093/infdis/jiu658 [PMid:25425699]
- Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020;63(3):364-74. doi: 10.1007/s11427-020-1643-8 [PMid:32048163]
- Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020; 382(12):1177-9.doi:10.1056/NEJMc2001737. [PMid:32074444]
- Guide to the Diagnosis and Treatment of COVID-19 - At Outpatient and Inpatient Service Levels - Eighth Edition: august 2020
- Karahasan Yagci A, Sarinoglu RC, Bilgin H, Yanılmaz Ö, Sayın E, Deniz G, et al. Relationship of the cycle threshold values of SARS-CoV-2 polymerase chain reaction and total severity score of computerized tomography in patients with COVID 19. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases. 2020;101:160-6.doi:10.1016/j.ijid.2020.09.1449 [PMid:32992013]
- Kleiboeker S, Cowden S, Grantham J, Nutt J, Tyler A, Berg A, et al. SARS-CoV-2 viral load assessment in respiratory samples. Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology. 2020; 129:104439.doi: 10.1016/j.jcv.2020.104439 [PMid:32674034]
- Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q, et al. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. BMJ (Clinical research ed). 2020; 369:m1443. doi: 10.1136/bmj.m1443 [PMid:32317267]
- Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Feb 10;41(2):145-151. Chinese. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003. [PMID: 32064853].
- Ingberg E, Ahlstrand E, Cajander P, Löf E, Sundqvist M, Wegener M, et al. RT-PCR cycle threshold value in combination with visual scoring of chest computed tomography at hospital admission predicts outcome in COVID-19. Infectious diseases (London, England). 2022;54(6):431-40.doi:10.1080/23744235.2022.2035428 [PMid:35114897]
- Choudhuri J, Carter J, Nelson R, Skalina K, Osterbur-Badhey M, Johnston A, et al. SARS-CoV-2 PCR cycle threshold at hospital admission associated with patient mortality. PloS one. 2020; 15(12):e0244777.
doi:10.1371/journal.pone.0244777 [PMid:33382805] - Miller EH, Zucker J, Castor D, Annavajhala MK, Sepulveda JL, Green DA, et al. Pretest Symptom Duration and Cycle Threshold Values for Severe Acute Respiratory Syndrome Coronavirus 2 Reverse-Transcription Polymerase Chain Reaction Predict Coronavirus Disease 2019 Mortality. Open forum infectious diseases. 2021; 8(2):ofab003. doi:10.1093/ofid/ofab003 [PMid:33604401]
- Blanco-Melo D, Nilsson-Payant BE, Liu WC, Uhl S, Hoagland D, Møller R, et al. Imbalanced Host Response to SARS-CoV-2 Drives Development of COVID-19. Cell. 2020; 181(5):1036-45.e9.
doi:10.1016/j.cell.2020.04.026 [PMid:32416070] - Rajyalakshmi B, Samavedam S, Reddy PR, Aluru N. Prognostic Value of "Cycle Threshold" in Confirmed COVID-19 Patients. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2021; 25(3):322-6. doi:10.5005/jp-journals-10071-23765[PMid:33790515]
- Jemmieh K, Tawengi M, Alyaarabi T, Hassona A, Ghoul I, Al Abdulla S, et al. No Association between Ct Value and COVID-19 Severity and Mortality in Qatar. International journal of general medicine. 2023;16:5323-31. doi:10.2147/IJGM.S404696 [PMid:38021068]
- Farfour E, Mellot F, Lesprit P, Vasse M. SARS-CoV-2 RT-PCR and Chest CT, two complementary approaches for COVID-19 diagnosis. Japanese journal of radiology. 2020; 38(12):1209-10.
doi:10.1007/s11604-020-01016-1 [PMid:32661878] - Mahallawi WH, Alsamiri AD, Dabbour AF, Alsaeedi H, Al-Zalabani AH. Association of Viral Load in SARS-CoV-2 Patients with Age and Gender. Frontiers in medicine. 2021;8:608215
doi:10.3389/fmed.2021.608215 [PMid:33585523]
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