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.
【저자키워드】 COVID-19, Mortality, severity, predictive biomarker, outcomes, Viral load, Sequelae, cycle threshold, SARS-CoV-2 swab, 【초록키워드】 coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, coronavirus, Hospitalized, disease severity, Diagnosis, oxygen, Symptom, novel coronavirus disease, severe acute respiratory syndrome Coronavirus, database, Symptoms, Novel coronavirus, clinical manifestations, Nasopharyngeal swab, survival, symptomatic, Signs and symptoms, Patient, Clinical management, Hospital admission, Swab, respiratory, group, quantification, resource, predict, prognostic biomarker, diagnose, marker, lethality, Predictive, acute respiratory syndrome, acute respiratory syndrome coronavirus, median time, diagnoses, interview, COVID-19-related death, oxygen support, COVID-19 emergency, FIVE, Randomly, collected, required, stratified, 【제목키워드】 SARS-CoV-2, cycle, value,