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?:abstract
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SARS-COV-2 (COVID-19) is a novel virus that has caused over 28 million cases worldwide and over 900,000 deaths since early 2020, rightfully being classified as a pandemic. COVID-19 is diagnosed via PCR testing which looks at cycle threshold values of two genes, N2 and E. This study examined cycle threshold values of COVID-positive patients at the VA hospital in Reno as well as other lab values and co-morbidities to determine if any could aid clinicians in predicting the need for hospitalization and higher levels of care. Multiple variables, including N2 cycle threshold (CT) value, absolute lymphocyte count (ALC), D-dimer, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen and ferritin were evaluated for potential associations with N2 CT value as well as required level of care (based on WHO ordinal score). The results suggest that patients with a N2 cycle threshold value less than 34 are 4 times more likely to have WHO ordinal scores of 4-8 (p=0.0021) while controlling for age and comorbidities (DM, cardiac, kidney and lung disease). Patients of age of 55 or greater were 15.18 times more likely to have WHO ordinal scores of 4-8 (p=0.012) controlling for N2 CT value and co-morbidities. Furthermore, patients with ALC less than 1 were 5.88 times more likely to have WHO ordinal score of 4-8 (p= 0.00024). N2 cycle threshold values also appear to be associated with many commonly obtained markers such as absolute lymphocyte count, white blood cell count, C-reactive protein and D-dimer. Patients with N2 CT values less than 34 were 3.49 times more likely to have ALC values less than 1, controlling for age and comorbidities (p=0.0072) while patients 55 or older were 6.66 times more likely to have ALC less than 1 (p=0.027). Finally, this study confirms previous conclusions that patients with advanced age had more severe infections and thus will likely require higher levels of care. This article is protected by copyright. All rights reserved.
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