Association of different biomarkers and CT value of RT-PCR with mortality in COVID-19 cases attended at tertiary care centre in India
Keywords:
SARS-CoV-2, RT-PCR, cycle thresholds (CT), biochemical markers, COVID-19, RdRpAbstract
Background: Severe Acute Respiratory Syndrome- Corona Virus-2 (SARS-CoV-2) infection becomes the pandemic of coronavirus disease 2019 (COVID-19) shows drastic changes in health care system.
Aims and objectives: 1) To assess different biomarkers in COVID-19 cases, 2) To correlate biomarkers with cycle threshold (CT) value of Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and it’s role for prognosis of severe cases.
Material and Methods: Consecutive patients with positive for SARS-CoV-2 by RT-PCR with CT value less than 36 were included. A CT values were found for envelope (E-gene) as a screening gene and RNA dependent RNA polymerase (RdRp) as a confirmatory gene were amplified during RT-PCR. The severity of illness was assessed using different biochemical parameters for C-reactive protein (CRP), serum ferritin, D-dimer, lactate dehydrogenase (LDH), serum urea, and creatinine.
Results: We enrolled 395 SARS-CoV-2 positive symptomatic patients. Among these, 322 (81.5%) were recovered and remaining succumbed 73 (18.5%). The mean age and distribution of gender were similar among death vs. recovered patients. We found that death seen in more severe cases 56/91 (61.5%), while recovery was good in mild-moderate [287/304 (94.4%)]. CRP was significantly higher among death than recovered cases (p<0.05). D-dimer, serum ferritin and LDH were also elevated among death alone and also in severe cases except serum ferritin.
Conclusions: We concluded that, mortality occurs more in patients with lower CT values (or early peak) than recovered cases (p < 0.001). The elevated level of CRP, serum ferritin, D-dimer and LDH including lower value of CT are associated with higher mortality in severe cases of COVID-19.
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