Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Abstract Background Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has principally been performed through the use of real-time reverse-transcription polymerase chain reaction testing. Results of such tests can be reported as cycle threshold (Ct) values, which may...

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Veröffentlicht in:Clinical infectious diseases 2021-06, Vol.72 (11), p.e761-e767
Hauptverfasser: Salvatore, Phillip P, Dawson, Patrick, Wadhwa, Ashutosh, Rabold, Elizabeth M, Buono, Sean, Dietrich, Elizabeth A, Reses, Hannah E, Vuong, Jeni, Pawloski, Lucia, Dasu, Trivikram, Bhattacharyya, Sanjib, Pevzner, Eric, Hall, Aron J, Tate, Jacqueline E, Kirking, Hannah L
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container_end_page e767
container_issue 11
container_start_page e761
container_title Clinical infectious diseases
container_volume 72
creator Salvatore, Phillip P
Dawson, Patrick
Wadhwa, Ashutosh
Rabold, Elizabeth M
Buono, Sean
Dietrich, Elizabeth A
Reses, Hannah E
Vuong, Jeni
Pawloski, Lucia
Dasu, Trivikram
Bhattacharyya, Sanjib
Pevzner, Eric
Hall, Aron J
Tate, Jacqueline E
Kirking, Hannah L
description Abstract Background Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has principally been performed through the use of real-time reverse-transcription polymerase chain reaction testing. Results of such tests can be reported as cycle threshold (Ct) values, which may provide semi-quantitative or indirect measurements of viral load. Previous reports have examined temporal trends in Ct values over the course of a SARS-CoV-2 infection. Methods Using testing data collected during a prospective household transmission investigation of outpatient and mild coronavirus disease 2019 cases, we examined the relationships between Ct values of the viral RNA N1 target and demographic, clinical, and epidemiological characteristics collected through participant interviews and daily symptom diaries. Results We found that Ct values are lowest (corresponding to a higher viral RNA concentration) soon after symptom onset and are significantly correlated with the time elapsed since onset (P 
doi_str_mv 10.1093/cid/ciaa1469
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Results of such tests can be reported as cycle threshold (Ct) values, which may provide semi-quantitative or indirect measurements of viral load. Previous reports have examined temporal trends in Ct values over the course of a SARS-CoV-2 infection. Methods Using testing data collected during a prospective household transmission investigation of outpatient and mild coronavirus disease 2019 cases, we examined the relationships between Ct values of the viral RNA N1 target and demographic, clinical, and epidemiological characteristics collected through participant interviews and daily symptom diaries. Results We found that Ct values are lowest (corresponding to a higher viral RNA concentration) soon after symptom onset and are significantly correlated with the time elapsed since onset (P &lt; .001); within 7 days after symptom onset, the median Ct value was 26.5, compared with a median Ct value of 35.0 occurring 21 days after onset. Ct values were significantly lower among participants under 18 years of age (P = .01) and those reporting upper respiratory symptoms at the time of sample collection (P = .001), and were higher among participants reporting no symptoms (P = .05). Conclusions These results emphasize the importance of early testing for SARS-CoV-2 among individuals with symptoms of respiratory illness, and allow cases to be identified and isolated when their viral shedding may be highest. Cycle threshold values were lower among coronavirus disease 2019 patients under 18 years of age and those reporting upper respiratory symptoms at sample collection, and were correlated with the time since onset, indicating those populations who may be most infectious.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciaa1469</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>Clinical infectious diseases, 2021-06, Vol.72 (11), p.e761-e767</ispartof><rights>Published by Oxford University Press for the Infectious Diseases Society of America 2020. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c338t-f853016972ee32361d3396b92485b39cd145083764acd21648abd531cf22f5403</citedby><cites>FETCH-LOGICAL-c338t-f853016972ee32361d3396b92485b39cd145083764acd21648abd531cf22f5403</cites><orcidid>0000-0001-8305-9056</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Salvatore, Phillip P</creatorcontrib><creatorcontrib>Dawson, Patrick</creatorcontrib><creatorcontrib>Wadhwa, Ashutosh</creatorcontrib><creatorcontrib>Rabold, Elizabeth M</creatorcontrib><creatorcontrib>Buono, Sean</creatorcontrib><creatorcontrib>Dietrich, Elizabeth A</creatorcontrib><creatorcontrib>Reses, Hannah E</creatorcontrib><creatorcontrib>Vuong, Jeni</creatorcontrib><creatorcontrib>Pawloski, Lucia</creatorcontrib><creatorcontrib>Dasu, Trivikram</creatorcontrib><creatorcontrib>Bhattacharyya, Sanjib</creatorcontrib><creatorcontrib>Pevzner, Eric</creatorcontrib><creatorcontrib>Hall, Aron J</creatorcontrib><creatorcontrib>Tate, Jacqueline E</creatorcontrib><creatorcontrib>Kirking, Hannah L</creatorcontrib><title>Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)</title><title>Clinical infectious diseases</title><description>Abstract Background Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has principally been performed through the use of real-time reverse-transcription polymerase chain reaction testing. Results of such tests can be reported as cycle threshold (Ct) values, which may provide semi-quantitative or indirect measurements of viral load. Previous reports have examined temporal trends in Ct values over the course of a SARS-CoV-2 infection. Methods Using testing data collected during a prospective household transmission investigation of outpatient and mild coronavirus disease 2019 cases, we examined the relationships between Ct values of the viral RNA N1 target and demographic, clinical, and epidemiological characteristics collected through participant interviews and daily symptom diaries. Results We found that Ct values are lowest (corresponding to a higher viral RNA concentration) soon after symptom onset and are significantly correlated with the time elapsed since onset (P &lt; .001); within 7 days after symptom onset, the median Ct value was 26.5, compared with a median Ct value of 35.0 occurring 21 days after onset. Ct values were significantly lower among participants under 18 years of age (P = .01) and those reporting upper respiratory symptoms at the time of sample collection (P = .001), and were higher among participants reporting no symptoms (P = .05). Conclusions These results emphasize the importance of early testing for SARS-CoV-2 among individuals with symptoms of respiratory illness, and allow cases to be identified and isolated when their viral shedding may be highest. Cycle threshold values were lower among coronavirus disease 2019 patients under 18 years of age and those reporting upper respiratory symptoms at sample collection, and were correlated with the time since onset, indicating those populations who may be most infectious.</description><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU1PwzAMhisEEmNw4wfkxpAo5KPp0uNUxoeEBNrGrlWWuiwobUrSTuqv4a-SaXBFsmUfHr-W_UbRJcG3BGfsTukypJQkSbOjaEQ4m8Ypz8hx6DEXcSKYOI3OvP_EmBCB-Sj6nre6hFpbYz-0kgbl1jkwsgOPbIXerBlqcNIDyrdSN2gBUnXaNigflAG02jrwW2tKtJamDzMB6baA7qGDAxdElrADB2im-g6CgG-1k511A1oOTelsDfultpE77XqPKJosZ4tlnNt1TK_Po5NKGg8Xv3UcvT_MV_lT_PL6-JzPXmLFmOjiSnCGSZpNKQCjLCUlY1m6yWgi-IZlqiQJx4JN00SqkpI0EXJTckZURWnFE8zG0eSg2zr7FQ7pilp7BcbIBmzvC5qEnwoRIqA3B1Q5672DqmidrqUbCoKLvQ9F8KH48yHgVwfc9u3_5A8XwYoO</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Salvatore, Phillip P</creator><creator>Dawson, Patrick</creator><creator>Wadhwa, Ashutosh</creator><creator>Rabold, Elizabeth M</creator><creator>Buono, Sean</creator><creator>Dietrich, Elizabeth A</creator><creator>Reses, Hannah E</creator><creator>Vuong, Jeni</creator><creator>Pawloski, Lucia</creator><creator>Dasu, Trivikram</creator><creator>Bhattacharyya, Sanjib</creator><creator>Pevzner, Eric</creator><creator>Hall, Aron J</creator><creator>Tate, Jacqueline E</creator><creator>Kirking, Hannah L</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8305-9056</orcidid></search><sort><creationdate>20210601</creationdate><title>Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)</title><author>Salvatore, Phillip P ; Dawson, Patrick ; Wadhwa, Ashutosh ; Rabold, Elizabeth M ; Buono, Sean ; Dietrich, Elizabeth A ; Reses, Hannah E ; Vuong, Jeni ; Pawloski, Lucia ; Dasu, Trivikram ; Bhattacharyya, Sanjib ; Pevzner, Eric ; Hall, Aron J ; Tate, Jacqueline E ; Kirking, Hannah L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c338t-f853016972ee32361d3396b92485b39cd145083764acd21648abd531cf22f5403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Salvatore, Phillip P</creatorcontrib><creatorcontrib>Dawson, Patrick</creatorcontrib><creatorcontrib>Wadhwa, Ashutosh</creatorcontrib><creatorcontrib>Rabold, Elizabeth M</creatorcontrib><creatorcontrib>Buono, Sean</creatorcontrib><creatorcontrib>Dietrich, Elizabeth A</creatorcontrib><creatorcontrib>Reses, Hannah E</creatorcontrib><creatorcontrib>Vuong, Jeni</creatorcontrib><creatorcontrib>Pawloski, Lucia</creatorcontrib><creatorcontrib>Dasu, Trivikram</creatorcontrib><creatorcontrib>Bhattacharyya, Sanjib</creatorcontrib><creatorcontrib>Pevzner, Eric</creatorcontrib><creatorcontrib>Hall, Aron J</creatorcontrib><creatorcontrib>Tate, Jacqueline E</creatorcontrib><creatorcontrib>Kirking, Hannah L</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Salvatore, Phillip P</au><au>Dawson, Patrick</au><au>Wadhwa, Ashutosh</au><au>Rabold, Elizabeth M</au><au>Buono, Sean</au><au>Dietrich, Elizabeth A</au><au>Reses, Hannah E</au><au>Vuong, Jeni</au><au>Pawloski, Lucia</au><au>Dasu, Trivikram</au><au>Bhattacharyya, Sanjib</au><au>Pevzner, Eric</au><au>Hall, Aron J</au><au>Tate, Jacqueline E</au><au>Kirking, Hannah L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)</atitle><jtitle>Clinical infectious diseases</jtitle><date>2021-06-01</date><risdate>2021</risdate><volume>72</volume><issue>11</issue><spage>e761</spage><epage>e767</epage><pages>e761-e767</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Abstract Background Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has principally been performed through the use of real-time reverse-transcription polymerase chain reaction testing. Results of such tests can be reported as cycle threshold (Ct) values, which may provide semi-quantitative or indirect measurements of viral load. Previous reports have examined temporal trends in Ct values over the course of a SARS-CoV-2 infection. Methods Using testing data collected during a prospective household transmission investigation of outpatient and mild coronavirus disease 2019 cases, we examined the relationships between Ct values of the viral RNA N1 target and demographic, clinical, and epidemiological characteristics collected through participant interviews and daily symptom diaries. Results We found that Ct values are lowest (corresponding to a higher viral RNA concentration) soon after symptom onset and are significantly correlated with the time elapsed since onset (P &lt; .001); within 7 days after symptom onset, the median Ct value was 26.5, compared with a median Ct value of 35.0 occurring 21 days after onset. Ct values were significantly lower among participants under 18 years of age (P = .01) and those reporting upper respiratory symptoms at the time of sample collection (P = .001), and were higher among participants reporting no symptoms (P = .05). Conclusions These results emphasize the importance of early testing for SARS-CoV-2 among individuals with symptoms of respiratory illness, and allow cases to be identified and isolated when their viral shedding may be highest. Cycle threshold values were lower among coronavirus disease 2019 patients under 18 years of age and those reporting upper respiratory symptoms at sample collection, and were correlated with the time since onset, indicating those populations who may be most infectious.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/cid/ciaa1469</doi><orcidid>https://orcid.org/0000-0001-8305-9056</orcidid><oa>free_for_read</oa></addata></record>
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title Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
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