SARS-CoV-2 Ct values and COVID-19 symptoms in patients with haematological malignancies in South Africa
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase polymerase chain reaction (RT-PCR) cycle threshold (Ct) values serve as surrogate markers for estimating viral load. Their usefulness in patients with haematological malignancies and COVID-19 has not been...
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| Language: | English |
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AOSIS
2025-01-01
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| Series: | Southern African Journal of Infectious Diseases |
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| Online Access: | https://sajid.co.za/index.php/sajid/article/view/676 |
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| author | Keitumetsi L. Sothoane Sarah A. Van Blydenstein Vinitha Philip Jeannette Wadula |
| author_facet | Keitumetsi L. Sothoane Sarah A. Van Blydenstein Vinitha Philip Jeannette Wadula |
| author_sort | Keitumetsi L. Sothoane |
| collection | DOAJ |
| description | Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase polymerase chain reaction (RT-PCR) cycle threshold (Ct) values serve as surrogate markers for estimating viral load. Their usefulness in patients with haematological malignancies and COVID-19 has not been studied in the South African context.
Objectives: To evaluate if a Ct value 30 can predict COVID-19 symptom development in adult patients with haematological malignancies.
Method: A retrospective cohort study on adult patients with haematological malignancies and COVID-19 was conducted at Chris Hani Baragwanath Academic Hospital from 01 July 2020 to 31 July 2021. The relationship between Ct values, symptoms and disease severity, along with changes over time were evaluated.
Results: Among 53 patients (50.9% male, median age of 38 years), Ct values 30 did not significantly predict COVID-19 symptom development (p = 0.417). However, severe disease correlated with lower Ct values (p = 0.002). No significant difference in the duration (days) from positive to negative tests was found between symptomatic and asymptomatic patients, and by severity of disease in the symptomatic patients. Lymphopenia was associated with severe disease, and those with lymphoid malignancies experienced longer viral shedding.
Conclusion: Patients with haematological malignancies can exhibit symptoms at any Ct value but lower Ct values indicate more severe disease. This information can be critical for chemotherapy timing to minimize adverse outcomes.
Contribution: The findings suggest a potential benefit in delaying chemotherapy at any Ct value as patients could present with acute SARS-CoV-2 infection at higher Ct values, and therefore face increased risk of adverse outcomes with early chemotherapy initiation. |
| format | Article |
| id | doaj-art-bd0abd77df3f499e8f106d8615cecac3 |
| institution | Kabale University |
| issn | 2312-0053 2313-1810 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of Infectious Diseases |
| spelling | doaj-art-bd0abd77df3f499e8f106d8615cecac32025-01-14T12:21:36ZengAOSISSouthern African Journal of Infectious Diseases2312-00532313-18102025-01-01401e1e910.4102/sajid.v40i1.676329SARS-CoV-2 Ct values and COVID-19 symptoms in patients with haematological malignancies in South AfricaKeitumetsi L. Sothoane0Sarah A. Van Blydenstein1Vinitha Philip2Jeannette Wadula3Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, JohannesburgDepartment of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Division of Pulmonology, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, JohannesburgDepartment of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Division of Clinical Haematology, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, JohannesburgDepartment of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Clinical Microbiology & Infectious Diseases, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and National Health Laboratory Service, University of the Witwatersrand, JohannesburgBackground: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase polymerase chain reaction (RT-PCR) cycle threshold (Ct) values serve as surrogate markers for estimating viral load. Their usefulness in patients with haematological malignancies and COVID-19 has not been studied in the South African context. Objectives: To evaluate if a Ct value 30 can predict COVID-19 symptom development in adult patients with haematological malignancies. Method: A retrospective cohort study on adult patients with haematological malignancies and COVID-19 was conducted at Chris Hani Baragwanath Academic Hospital from 01 July 2020 to 31 July 2021. The relationship between Ct values, symptoms and disease severity, along with changes over time were evaluated. Results: Among 53 patients (50.9% male, median age of 38 years), Ct values 30 did not significantly predict COVID-19 symptom development (p = 0.417). However, severe disease correlated with lower Ct values (p = 0.002). No significant difference in the duration (days) from positive to negative tests was found between symptomatic and asymptomatic patients, and by severity of disease in the symptomatic patients. Lymphopenia was associated with severe disease, and those with lymphoid malignancies experienced longer viral shedding. Conclusion: Patients with haematological malignancies can exhibit symptoms at any Ct value but lower Ct values indicate more severe disease. This information can be critical for chemotherapy timing to minimize adverse outcomes. Contribution: The findings suggest a potential benefit in delaying chemotherapy at any Ct value as patients could present with acute SARS-CoV-2 infection at higher Ct values, and therefore face increased risk of adverse outcomes with early chemotherapy initiation.https://sajid.co.za/index.php/sajid/article/view/676severe acute respiratory syndrome coronavirus 2 (sars-cov-2)covid-19cycle threshold valuehaematological malignanciessymptomsviral sheddingchemotherapy |
| spellingShingle | Keitumetsi L. Sothoane Sarah A. Van Blydenstein Vinitha Philip Jeannette Wadula SARS-CoV-2 Ct values and COVID-19 symptoms in patients with haematological malignancies in South Africa Southern African Journal of Infectious Diseases severe acute respiratory syndrome coronavirus 2 (sars-cov-2) covid-19 cycle threshold value haematological malignancies symptoms viral shedding chemotherapy |
| title | SARS-CoV-2 Ct values and COVID-19 symptoms in patients with haematological malignancies in South Africa |
| title_full | SARS-CoV-2 Ct values and COVID-19 symptoms in patients with haematological malignancies in South Africa |
| title_fullStr | SARS-CoV-2 Ct values and COVID-19 symptoms in patients with haematological malignancies in South Africa |
| title_full_unstemmed | SARS-CoV-2 Ct values and COVID-19 symptoms in patients with haematological malignancies in South Africa |
| title_short | SARS-CoV-2 Ct values and COVID-19 symptoms in patients with haematological malignancies in South Africa |
| title_sort | sars cov 2 ct values and covid 19 symptoms in patients with haematological malignancies in south africa |
| topic | severe acute respiratory syndrome coronavirus 2 (sars-cov-2) covid-19 cycle threshold value haematological malignancies symptoms viral shedding chemotherapy |
| url | https://sajid.co.za/index.php/sajid/article/view/676 |
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