SARS-CoV-2 RT-PCR 周期阈值及其与住院小儿 covid-19 患者疾病严重程度和死亡率的关系。

Aubrey Artienda, Jay Ron Padua
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Median day of illness on swab collection was 4 days. Majority presented with symptoms such as fever (54%), cough (22%) and dyspnea (22%). Eighty-four percent had co-morbidities, of which majority were cancer and neurologic diseases. Median Ct value was 30.81. Fifty-four percent had high Ct values. The median age of patients with a high Ct value was significantly lower than other cohorts. The median day of illness of patients with low Ct value was significantly shorter than other cohorts. There was no significant difference across the terciles in terms of presence of co-morbidities. Majority of patients for each cohort had high Ct values. There was no significant association between Ct value and COVID-19 disease severity on admission. Nearly fifty percent had critical disease and the all-cause mortality rate was 21.61%. There was no significant association between Ct value and mortality. 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摘要

研究目的本研究确定 SARS-CoV-2 RT-PCR 周期阈值 (Ct) 值与 COVID-19 住院儿科患者疾病严重程度和死亡率的关系。研究方法这是一项回顾性队列研究,研究对象是 2020 年 9 月 1 日至 2022 年 8 月 31 日期间 0-18 岁经 SARS-CoV-2 RT-PCR 确诊为 COVID-19 的患者。该队列分为高(>30)、中(>20)和低(<=20)Ct 值患者。Ct值与疾病严重程度之间的关系采用Chi-square检验,Ct值与死亡率之间的关系采用Logistic回归。结果:共纳入 236 名患者,男性居多。中位年龄为 7 岁。大多数属于 0-5 岁年龄组。大多数为严重至危重的 COVID-19 病例。采集拭子时的中位发病日为 4 天。大多数人表现出发热(54%)、咳嗽(22%)和呼吸困难(22%)等症状。84%的患者有并发症,其中大部分是癌症和神经系统疾病。中位 Ct 值为 30.81。54%的患者 Ct 值偏高。高 Ct 值患者的中位年龄明显低于其他组群。低 Ct 值患者的中位患病天数明显短于其他组群。各组别在并发症方面没有明显差异。各组群中大多数患者的 Ct 值较高。入院时的 Ct 值与 COVID-19 疾病严重程度无明显关联。近50%的患者病情危重,全因死亡率为21.61%。Ct 值与死亡率之间无明显关联。结论:在控制了混杂因素后,Ct 值与疾病严重程度和全因死亡率无关。建议在今后的研究中对可能影响临床表现、病程、严重程度和预后的医疗干预、变异体的出现及其他因素进行研究。
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SARS-CoV-2 RT-PCR cycle threshold value and its association with disease severity and mortality among hospitalized pediatric covid-19 patients.
Objective: This study determined the association of SARS-CoV-2 RT-PCR cycle threshold (Ct) value with disease severity and mortality among hospitalized pediatric COVID-19 patients. Methodology: This is a retrospective cohort study of patients aged 0-18 years with SARS-CoV-2 RT-PCR-confirmed COVID-19 from 1-September-2020 to 31-August-2022. The cohort was divided into those with high (>30), medium (> 20) and low (
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