PDF(Pubmed)
Abstract：
Limited evidence exists on whether initial viral load and patient characteristics can predict unfavorable outcomes in future outbreaks of coronavirus disease 2019 (COVID-19). This retrospective cohort study examined the relationship between the initial viral load, patient characteristics, and outcomes during the second-wave COVID-19 outbreak in West Sumatra, Indonesia. We analyzed the COVID-19 patients admitted to a secondary hospital between the 1 June 2021 and the 31 August 2021. The initial viral load was determined using the real-time quantitative-polymerase chain reaction (RT-qPCR) cycle threshold (Ct) value, categorized as low (LIVL, Ct > 20) or high (HIVL, Ct ≤ 20). Multivariate logistic regression was used to assess the relationship between the initial viral load, age, sex, vaccination status, comorbidities, and outcomes, including disease severity, hospital stay length, ICU admission, invasive ventilation, and in-hospital mortality. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to assess the diagnostic performance of the initial Ct values in predicting COVID-19 outcomes. The study included 373 patients (median age [range]: 48 [0-94]; male: 40.21%; HIVL: 34.85%; unvaccinated: 86.06%; comorbidities: 52.01%). The HIVL patients significantly had a lower risk of developing severe/critical outcomes (OR: 0.506; 95% CI: 0.310-0.825; p = 0.006) and needing invasive ventilation (OR: 0.290; CI: 0.098-0.854; p = 0.025). The Ct value used to indicate severe/critical outcomes was 23.57. More severe outcomes were significantly observed in LIVL patients, those aged >60 years, males, unvaccinated individuals, and those with comorbidities. This study emphasizes the importance of primary prevention, early screening, and immediate care for COVID-19 in saving lives.
摘要：
关于初始病毒载量和患者特征是否可以预测2019年冠状病毒病(COVID-19)未来爆发的不利结果的证据有限。这项回顾性队列研究检查了初始病毒载量之间的关系，患者特征,以及西苏门答腊第二波COVID-19爆发期间的结果，印度尼西亚。我们分析了2021年6月1日至2021年8月31日期间二级医院收治的COVID-19患者。使用实时定量聚合酶链反应（RT-qPCR）循环阈值（Ct）值确定初始病毒载量，分类为低(LIVL，CT>20)或高(HIVL,Ct≤20)。多变量逻辑回归用于评估初始病毒载量之间的关系，年龄,性别,疫苗接种状况,合并症,和结果，包括疾病的严重程度,住院时间,入住ICU,有创通气,和住院死亡率。受试者工作特征（ROC）曲线和曲线下面积（AUC）用于评估初始Ct值在预测COVID-19结果中的诊断性能。该研究包括373名患者（中位年龄[范围]：48[0-94]；男性：40.21%；HIVL：34.85%；未接种疫苗：86.06%；合并症：52.01%）。HIVL患者发生严重/危急结局的风险显著降低(OR:0.506;95%CI:0.310-0.825;p=0.006)，需要有创通气(OR:0.290;CI:0.098-0.854;p=0.025)。用于指示严重/关键结果的Ct值为23.57。在LIVL患者中观察到更严重的结果，那些年龄>60岁的人，男性,未接种疫苗的人，和那些有合并症的人。这项研究强调了一级预防的重要性，早期筛查,以及对COVID-19拯救生命的即时护理。
