COVID-19 Hastalarında RT-PCR CT Değerleri ile Toraks BT Şiddet Skoru Arasındaki İlişki

Abstract

Amaç: Bu çalışmada, viral yük hakkında bilgi veren RT-PCR Cycles Threshold (Ct) değerleri ile akciğer tutulumunu göstermek için kullanılan Bilgisayarlı Tomografi şiddet skoru (BTŞS) arasındaki ilişkinin araştırması amaçlandı. Araçlar ve Yöntem: 1 Ocak 2021 ile 31 Kasım 2021 tarihleri arasında akciğer oskültasyon bulguları ve/veya posteroanterior akciğer grafisinde şüpheli bulguları olan ve RT-PCR testi pozitif çıkan toplam 162 hasta çalışmaya dahil edilmiştir. Olguların viral yükleri, akciğer tutulumu ve mortalite oranları hastaneye yatırıldıkları birimlere göre analiz edildi. Ayrıca, COVID-19, BTŞS, RT-PCR Ct viral yük değerleri ve yaşa eşlik eden komorbid hastalıklar arasındaki korelasyon incelendi. Bulgular: BTŞS yaş ile pozitif ve anlamlı bir korelasyon göstermiştir (p=0.017). İstatistiksel analiz, viral yük ile torasik tutulum arasında anlamlı bir korelasyon olmadığını ortaya koymuştur (p=0.663). Sonuç: Bu çalışmaya göre, COVID-19 hastalığının tanısında önemli bir yer tutan RT-PCR Ct değerleri ile toraks BT tutulumu arasında anlamlı bir korelasyon bulunmazken, akciğer tutulumu prevalansı ve olguların ölüm oranı yaşla birlikte artmıştır. Ayrıca, CT-CS skoru ile yaş arasında anlamlı bir korelasyon gözlenmiştir. Bu bulgular, bu alanda gelecekte yapılacak derinlemesine araştırmaların önünü açarak konunun daha iyi anlaşılmasını sağlayacaktır.

Keywords

• bilgisayarlı tomografi
• COVID-19
• tomografi
• torasik tutulum
• viral yük

Relationship between RT-PCR Threshold Cycle Values and Thorax CT Severity Score in COVID-19 Patients

Abstract

Purpose: In this study, we aimed to investigate the relationship between RT-PCR Cycles Threshold (Ct) values, which provide information about the viral load, and CT severity score (CTSS), which is used to demonstrate lung involvement. Materials and Methods: Between January 1, 2021 and November 30, 2021, a total of 162 patients with lung auscultation findings and/or suspicious findings on posteroanterior chest radiography, along with a positive RT-PCR test, were included in the study. Viral loads, lung involvement, and mortality rates of the cases were analyzed based on the units in which they were hospitalized. Additionally, we investigated the correlation between comorbid diseases associated with COVID-19, CTSS (CT severity score), RT-PCR Ct viral load values, and age. Results: The CTSS showed a positive and significant correlation with age (p=0.017). Statistical analysis revealed no significant correlation between viral load and thoracic involvement (p=0.663). Conclusion: According to the present study, no significant correlation was found between RT-PCR Ct values, which play a crucial role in the diagnosis of COVID-19, and thoracic CT involvement. However, the prevalence of lung involvement and the mortality rate of the cases increased with age. Additionally, a significant correlation was observed between the CT severity score (CT-SS) and age. These findings pave the way for future in-depth research in this field, fostering a better understanding of the subject matter.

Keywords

• computed tomography
• COVID-19
• thoracic involvement
• tomography
• viral load

References

1. 1. Zhou M, Zhang X, Qu J. Coronavirus disease 2019 (COVID-19): a clinical update. Front Med. 2020; 14(2):126-135.
2. 2. Trunfio M, Venuti F, Alladio F, et al. Diagnostic SARS-CoV-2 Cycle Threshold Value Predicts Disease Severity, Survival, and Six-Month Sequelae in COVID-19 Symptomatic Patients. Viruses. 2021;13(2):281.
3. 3. 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):573-586.
4. 4. Tom MR, Mina MJ. To Interpret the SARS-CoV-2 Test, Consider the Cycle Threshold Value. Clin Infect Dis. 2020;71(16):2252-2254.
5. 5. Gülbudak H, Karvar Ş, Soydan G, et al. Comparison of Real Time PCR Cycle Threshold Values in Symptomatic and Asymptomatic COVID-19 Patients. Mikrobiyol Bul. 2021;55(3):435-444.
6. 6. Al-Mosawe AM, Abdulwahid H Mohammed, Fayadh NAH. Spectrum of CT appearance and CT severity index of COVID-19 pulmonary infection in correlation with age, sex, and PCR test: an Iraqi experience. Egypt J Radiol Nucl Med. 2021;52(1):40.
7. 7. Yang R, Li X, Liu H, et al. Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19. Radiol Cardiothorac Imaging. 2020;2(2):200047.
8. 8. Shah S, Singhal T, Davar N, Thakkar P. No correlation between Ct values and severity of disease or mortality in patients with COVID 19 disease. Indian J Med Microbiol. 2021;39(1):116-117.

9. 9. Saeed GA, Gaba W, Shah A, et al. Correlation between Chest CT Severity Scores and the Clinical Parameters of Adult Patients with COVID-19 Pneumonia. Radiol Res Pract. 2021;2021(1):6697677.
10. 10. Caruso D, Zerunian M, Polici M, et al. Diagnostic performance of CT lung severity score and quantitative chest CT for stratification of COVID-19 patients. Radiol Med (Torino). 2022;127(3):309-317.
11. 11. Markewitz R, Torge A, Wandinger KP, et al. Analysis of SARS-CoV-2 reverse transcription-quantitative polymerase chain reaction cycle threshold values vis-à-vis anti-SARS-CoV-2 antibodies from a high incidence region. Int J Infect Dis. 2021;110:114-122.
12. 12. Singh V, Agarwal J, Garg J, Saqui̇B M, Das A, Sen M. Role of Cycle Threshold of RT-PCR in the Prediction of COVID-19 Cases. J Microbiol Infect Dis. 2021;11(3):132-139.
13. 13. De la Calle C, Lalueza A, Mancheño-Losa M, et al. Impact of viral load at admission on the development of respiratory failure in hospitalized patients with SARS-CoV-2 infection. Eur J Clin Microbiol Infect Dis. 2021;40(6):1209-1216.
14. 14. Shah VP, Farah WH, Hill JC, et al. Association Between SARS-CoV-2 Cycle Threshold Values and Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis. Open Forum Infect Dis. 2021;8(9):ofab453.
15. 15. Bakir A, Hosbul T, Cuce F, et al. Investigation of Viral Load Cycle Threshold Values in Patients with SARS-CoV-2 Associated Pneumonia with Real-Time PCR Method. J Infect Dev Ctries. 2021;15(10):1408-1414.
16. 16. Ayyildiz VA. Cardiothoracic Radiological Imaging and The Role of Artificial Intelligence in Covid-19. Med J SDU. 2021;28(Special issue-1):101-112.
17. 17. Jędrusik P, Gaciong Z, Sklinda K, Sierpiński R, Walecki J, Gujski M. Diagnostic role of chest computed tomography in coronavirus disease 2019. Pol Arch Intern Med. 2020;130(6):520-528.
18. 18. Wang Y, Dong C, Hu Y, et al. Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study. Radiology. 2020;296(2): 55-64.
19. 19. Karahasan Yagci A, Sarinoglu RC, Bilgin H, 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. Int J Infect Dis. 2020;101:160-166.
20. 20. Francone M, Iafrate F, Masci GM, et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol. 2020;30(12):6808-6817.
21. 21. Li K, Chen D, Chen S, et al. Predictors of fatality including radiographic findings in adults with COVID-19. Respir Res. 2020;21(1):146.
22. 22. Ejaz H, Alsrhani A, Zafar A, et al. COVID-19 and comorbidities: Deleterious impact on infected patients. J Infect Public Health. 2020;13(12):1833-1839.