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Diagnostic SARS-CoV-2 Cycle Threshold Value Predicts Disease Severity, Survival and 6-month Sequelae in COVID-19 Symptomatic Patients
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  • Mattia Trunfio,
  • Francesco Venuti,
  • Francesca Alladio,
  • Bianca Maria Longo,
  • Elisa Burdino,
  • Francesco Cerutti,
  • Valeria Ghisetti,
  • Roberto Bertucci,
  • Carlo Picco,
  • Stefano Bonora,
  • Giovanni Di Perri,
  • Andrea Calcagno
Mattia Trunfio
University of Torino

Corresponding Author:[email protected]

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Francesco Venuti
University of Torino
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Francesca Alladio
University of Torino
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Bianca Maria Longo
University of Torino
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Elisa Burdino
Microbiology and Molecular Biology Laboratory, “Amedeo di Savoia” Hospital, ASL Città di Torino
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Francesco Cerutti
Microbiology and Molecular Biology Laboratory, “Amedeo di Savoia” Hospital, ASL Città di Torino
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Valeria Ghisetti
Microbiology and Molecular Biology Laboratory, “Amedeo di Savoia” Hospital, ASL Città di Torino
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Roberto Bertucci
University of Torino
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Carlo Picco
Regional Department for Infectious Diseases and Emergency DIRMEI, ASL Città di Torino
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Stefano Bonora
University of Torino
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Giovanni Di Perri
University of Torino
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Andrea Calcagno
University of Torino
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Abstract

Background: No pathogen-specific prognostic biomarkers are yet available for SARS-CoV-2. We sought to assess whether SARS-CoV-2 cycle threshold value (Ct) at diagnosis may predict COVID-19 severity, clinical manifestations and 6-month sequelae. Methods: Hospitalised and outpatient cases were randomly sampled from the diagnoses of March and data collected after 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 nasal-pharyngeal swab at diagnosis: group A≤20.0, 20.028.0. Disease severity was classified according to a composite scale evaluating hospital admission, worst oxygen support required and survival. Results: One-hundred sixty-eight survivors and thirty-two deceased patients were included: 27.5% in A and B both, 45.0% in C. 90% of patients were symptomatic and 63.7% were hospitalised. Median time from COVID-19 onset to swab collection was 5 days. Lethality, number of comorbidities, disease severity, type and amount of signs and symptoms, as well as 6-month sequelae inversely distributed among the groups with respect to SARS-CoV-2 Ct. After adjusting for confounding, SARS-CoV-2 Ct at diagnosis was still associated with COVID-19-related death (p=0.023), disease severity (p=0.023), amount of signs and symptoms (p<0.01) and presence of sequelae (p<0.01). Conclusions: Early quantification of SARS-CoV-2 along the course of the disease may be a useful predictive marker to inform differential strategies of clinical management and resource allocation.
11 Feb 2021Published in Viruses volume 13 issue 2 on pages 281. 10.3390/v13020281