Cargando…
Time series analysis revealed prognostic value of continuous nasopharyngeal SARS-CoV-2 nucleic acid quantification for COVID-19: A retrospective study of >3000 COVID-19 patients from 2 centers
BACKGROUND: Early stratification of disease progression remains one of the major challenges towards the post-coronavirus disease 2019 (COVID-19) era. The clinical relevance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid load is debated due to the heterogeneity in pa...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Published by Elsevier B.V.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9832689/ https://www.ncbi.nlm.nih.gov/pubmed/36640930 http://dx.doi.org/10.1016/j.cca.2023.117227 |
_version_ | 1784868105050128384 |
---|---|
author | Wu, Zhiyuan Yang, Can Shen, Yutao Zhang, Qingyun Tang, Xuemei Wang, Di Xu, Yu Cao, Guojun Song, Xiaodong Ma, Yanchun Fan, Huajie Lu, Hailong Li, Yaju Li, Xiangyu Shen, Yiqin Zhang, Chen Zhu, Min Teng, Xiaoyan Du, Yuzhen Guan, Ming |
author_facet | Wu, Zhiyuan Yang, Can Shen, Yutao Zhang, Qingyun Tang, Xuemei Wang, Di Xu, Yu Cao, Guojun Song, Xiaodong Ma, Yanchun Fan, Huajie Lu, Hailong Li, Yaju Li, Xiangyu Shen, Yiqin Zhang, Chen Zhu, Min Teng, Xiaoyan Du, Yuzhen Guan, Ming |
author_sort | Wu, Zhiyuan |
collection | PubMed |
description | BACKGROUND: Early stratification of disease progression remains one of the major challenges towards the post-coronavirus disease 2019 (COVID-19) era. The clinical relevance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid load is debated due to the heterogeneity in patients’ underlying health conditions. We determined the prognostic value of nasopharyngeal viral load dynamic conversion for COVID-19. METHODS: The cycling threshold (Ct) values of 28,937 nasopharyngeal SARS-CoV-2 RT-PCRs were retrospectively collected from 3,364 COVID-19 patients during hospitalization and coordinated to the onset of disease progression. The ROC curve was utilized to determine the predictive performance of the rate of Ct value alteration between two consecutive RT-PCR runs within 48 h (ΔCt%) for disease transformation across patients with different COVID-19 severity and immune backgrounds, and further validated with 1,860 SARS-CoV-2 RT-PCR results from an independent validation cohort of 262 patients. For the 67 patients with severe COVID-19, Kaplan-Meier analysis was performed to evaluate the difference in survival between patients stratified by the magnitude of Ct value alteration between the late and early stages of hospitalization. RESULTS: The kinetics of viral nucleic acid conversion diversified across COVID-19 patients with different clinical characteristics and disease severities. The ΔCt% is a clinical characteristic- and host immune status-independent indicator for COVID-19 progression prediction (AUC = 0.79, 95 % CI = 0.76 to 0.81), which outperformed the canonical blood test markers, including c-reactive protein (AUC = 0.57, 95 % CI = 0.53 to 0.61), serum amyloid A (AUC = 0.61, 95 % CI = 0.54 to 0.68), lactate dehydrogenase (AUC = 0.61, 95 % CI = 0.56 to 0.67), d-dimer (AUC = 0.56, 95 % CI = 0.46 to 0.66), and lymphocyte count (AUC = 0.62, 95 % CI = 0.58 to 0.66). Patients with persistent high SARS-CoV-2 viral load (an increase of mean Ct value < 50 %) during the first 3 days of hospitalization demonstrated a significantly unfavorable survival (HR = 0.16, 95 % CI = 0.04 to 0.65, P = 2.41 × 10(–3)). CONCLUSIONS: Viral nucleic acid dynamics of SARS-CoV-2 eliminates the inter-patient variance of basic health conditions and therefore, can serve as a prognostic marker for COVID-19. |
format | Online Article Text |
id | pubmed-9832689 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Published by Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98326892023-01-11 Time series analysis revealed prognostic value of continuous nasopharyngeal SARS-CoV-2 nucleic acid quantification for COVID-19: A retrospective study of >3000 COVID-19 patients from 2 centers Wu, Zhiyuan Yang, Can Shen, Yutao Zhang, Qingyun Tang, Xuemei Wang, Di Xu, Yu Cao, Guojun Song, Xiaodong Ma, Yanchun Fan, Huajie Lu, Hailong Li, Yaju Li, Xiangyu Shen, Yiqin Zhang, Chen Zhu, Min Teng, Xiaoyan Du, Yuzhen Guan, Ming Clin Chim Acta Article BACKGROUND: Early stratification of disease progression remains one of the major challenges towards the post-coronavirus disease 2019 (COVID-19) era. The clinical relevance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid load is debated due to the heterogeneity in patients’ underlying health conditions. We determined the prognostic value of nasopharyngeal viral load dynamic conversion for COVID-19. METHODS: The cycling threshold (Ct) values of 28,937 nasopharyngeal SARS-CoV-2 RT-PCRs were retrospectively collected from 3,364 COVID-19 patients during hospitalization and coordinated to the onset of disease progression. The ROC curve was utilized to determine the predictive performance of the rate of Ct value alteration between two consecutive RT-PCR runs within 48 h (ΔCt%) for disease transformation across patients with different COVID-19 severity and immune backgrounds, and further validated with 1,860 SARS-CoV-2 RT-PCR results from an independent validation cohort of 262 patients. For the 67 patients with severe COVID-19, Kaplan-Meier analysis was performed to evaluate the difference in survival between patients stratified by the magnitude of Ct value alteration between the late and early stages of hospitalization. RESULTS: The kinetics of viral nucleic acid conversion diversified across COVID-19 patients with different clinical characteristics and disease severities. The ΔCt% is a clinical characteristic- and host immune status-independent indicator for COVID-19 progression prediction (AUC = 0.79, 95 % CI = 0.76 to 0.81), which outperformed the canonical blood test markers, including c-reactive protein (AUC = 0.57, 95 % CI = 0.53 to 0.61), serum amyloid A (AUC = 0.61, 95 % CI = 0.54 to 0.68), lactate dehydrogenase (AUC = 0.61, 95 % CI = 0.56 to 0.67), d-dimer (AUC = 0.56, 95 % CI = 0.46 to 0.66), and lymphocyte count (AUC = 0.62, 95 % CI = 0.58 to 0.66). Patients with persistent high SARS-CoV-2 viral load (an increase of mean Ct value < 50 %) during the first 3 days of hospitalization demonstrated a significantly unfavorable survival (HR = 0.16, 95 % CI = 0.04 to 0.65, P = 2.41 × 10(–3)). CONCLUSIONS: Viral nucleic acid dynamics of SARS-CoV-2 eliminates the inter-patient variance of basic health conditions and therefore, can serve as a prognostic marker for COVID-19. Published by Elsevier B.V. 2023-02-01 2023-01-11 /pmc/articles/PMC9832689/ /pubmed/36640930 http://dx.doi.org/10.1016/j.cca.2023.117227 Text en © 2023 Published by Elsevier B.V. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Wu, Zhiyuan Yang, Can Shen, Yutao Zhang, Qingyun Tang, Xuemei Wang, Di Xu, Yu Cao, Guojun Song, Xiaodong Ma, Yanchun Fan, Huajie Lu, Hailong Li, Yaju Li, Xiangyu Shen, Yiqin Zhang, Chen Zhu, Min Teng, Xiaoyan Du, Yuzhen Guan, Ming Time series analysis revealed prognostic value of continuous nasopharyngeal SARS-CoV-2 nucleic acid quantification for COVID-19: A retrospective study of >3000 COVID-19 patients from 2 centers |
title | Time series analysis revealed prognostic value of continuous nasopharyngeal SARS-CoV-2 nucleic acid quantification for COVID-19: A retrospective study of >3000 COVID-19 patients from 2 centers |
title_full | Time series analysis revealed prognostic value of continuous nasopharyngeal SARS-CoV-2 nucleic acid quantification for COVID-19: A retrospective study of >3000 COVID-19 patients from 2 centers |
title_fullStr | Time series analysis revealed prognostic value of continuous nasopharyngeal SARS-CoV-2 nucleic acid quantification for COVID-19: A retrospective study of >3000 COVID-19 patients from 2 centers |
title_full_unstemmed | Time series analysis revealed prognostic value of continuous nasopharyngeal SARS-CoV-2 nucleic acid quantification for COVID-19: A retrospective study of >3000 COVID-19 patients from 2 centers |
title_short | Time series analysis revealed prognostic value of continuous nasopharyngeal SARS-CoV-2 nucleic acid quantification for COVID-19: A retrospective study of >3000 COVID-19 patients from 2 centers |
title_sort | time series analysis revealed prognostic value of continuous nasopharyngeal sars-cov-2 nucleic acid quantification for covid-19: a retrospective study of >3000 covid-19 patients from 2 centers |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9832689/ https://www.ncbi.nlm.nih.gov/pubmed/36640930 http://dx.doi.org/10.1016/j.cca.2023.117227 |
work_keys_str_mv | AT wuzhiyuan timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT yangcan timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT shenyutao timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT zhangqingyun timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT tangxuemei timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT wangdi timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT xuyu timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT caoguojun timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT songxiaodong timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT mayanchun timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT fanhuajie timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT luhailong timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT liyaju timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT lixiangyu timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT shenyiqin timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT zhangchen timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT zhumin timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT tengxiaoyan timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT duyuzhen timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers AT guanming timeseriesanalysisrevealedprognosticvalueofcontinuousnasopharyngealsarscov2nucleicacidquantificationforcovid19aretrospectivestudyof3000covid19patientsfrom2centers |