Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
PLoS One. 2021 Oct 12;16(10):e0258421. doi: 10.1371/journal.pone.0258421. eCollection 2021.
We aimed to examine if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) cycle quantification (Cq) value, as a surrogate for SARS-CoV-2 viral load, could predict hospitalisation and disease severity in adult patients with coronavirus disease 2019 (COVID-19).
We performed a prospective cohort study of adult patients with PCR positive SARS-CoV-2 airway samples including all out-patients registered at the Department of Infectious Diseases, Odense University Hospital (OUH) March 9-March 17 2020, and all hospitalised patients at OUH March 10-April 21 2020. To identify associations between Cq-values and a) hospital admission and b) a severe outcome, logistic regression analyses were used to compute odds ratios (OR) and 95% Confidence Intervals (CI), adjusting for confounding factors (aOR).
We included 87 non-hospitalised and 82 hospitalised patients. The median baseline Cq-value was 25.5 (interquartile range 22.3-29.0). We found a significant association between increasing Cq-value and hospital-admission in univariate analysis (OR 1.11, 95% CI 1.04-1.19). However, this was due to an association between time from symptom onset to testing and Cq-values, and no association was found in the adjusted analysis (aOR 1.08, 95% CI 0.94-1.23). In hospitalised patients, a significant association between lower Cq-values and higher risk of severe disease was found (aOR 0.89, 95% CI 0.81-0.98), independent of timing of testing.
SARS-CoV-2 PCR Cq-values in outpatients correlated with time after symptom onset, but was not a predictor of hospitalisation. However, in hospitalised patients lower Cq-values were associated with higher risk of severe disease.
我们旨在研究严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）聚合酶链反应（PCR）循环定量（Cq）值是否可以作为SARS-CoV-2病毒载量的替代指标，来预测成人 2019 冠状病毒病（COVID-19）患者的住院和疾病严重程度。
我们对 2020 年 3 月 9 日至 3 月 17 日在奥胡斯大学医院传染病科登记的所有 SARS-CoV-2 呼吸道样本 PCR 阳性的门诊成年患者，以及 2020 年 3 月 10 日至 4 月 21 日在奥胡斯大学医院住院的所有患者进行了前瞻性队列研究。为了确定 Cq 值与 a）住院和 b）严重结局之间的关联，我们使用逻辑回归分析计算了比值比（OR）和 95％置信区间（CI），并对混杂因素进行了调整（aOR）。
我们纳入了 87 名非住院患者和 82 名住院患者。中位基线 Cq 值为 25.5（四分位距 22.3-29.0）。在单变量分析中，我们发现 Cq 值的增加与住院之间存在显著关联（OR 1.11，95％CI 1.04-1.19）。然而，这是由于症状出现到检测之间的时间与 Cq 值之间的关联，而在调整后的分析中则没有发现关联（aOR 1.08，95％CI 0.94-1.23）。在住院患者中，我们发现 Cq 值越低与严重疾病风险越高之间存在显著关联（aOR 0.89，95％CI 0.81-0.98），这与检测时间无关。
门诊患者的 SARS-CoV-2 PCR Cq 值与症状出现后的时间相关，但不能预测住院。然而，在住院患者中，较低的 Cq 值与严重疾病的风险增加相关。
