Systematic review on the association between respiratory virus real-time PCR cycle threshold values and clinical presentation or outcomes.
J Antimicrob Chemother
; 76(Suppl 3): iii33-iii49, 2021 09 23.
Article
in English
| MEDLINE | ID: covidwho-1664107
ABSTRACT
OBJECTIVES:
It is unclear whether real-time (rt)-PCR cycle threshold (Ct) values can be utilized to guide clinical and infection-control decisions. This systematic review assesses the association between respiratory pathogen rt-PCR Ct values and clinical presentation or outcomes.METHODS:
We searched MEDLINE, EMBASE and Cochrane library databases on 14-17 January 2020 for studies reporting the presence or absence of an association between Ct values and clinical presentation or outcomes, excluding animal studies, reviews, meta-analyses, and non-English language studies.RESULTS:
Among 33 studies identified (reporting on between 9 and 4918 participants by pathogen), influenza (nâ=â11 studies; 4918 participants), human rhinovirus (HRV, nâ=â11; 2012) and respiratory syncytial virus (RSV, nâ=â8; 3290) were the most-studied pathogens. Low influenza Ct values were associated with mortality in 1/3 studies, with increased disease severity/duration or ICU admission in 3/9, and with increased hospitalization or length of hospital stay (LOS) in 1/6. Low HRV Ct values were associated with increased disease severity/duration or ICU admission in 3/10 studies, and with increased hospitalization or LOS in 1/3. Low RSV Ct values were associated with increased disease severity/duration or ICU admission in 3/6 studies, and with increased hospitalization or LOS in 4/4. Contradictory associations were also identified for other respiratory pathogens.CONCLUSIONS:
Respiratory infection Ct values may inform clinical and infection-control decisions. However, the study heterogeneity observed in this review highlights the need for standardized workflows to utilize Ct values as a proxy of genomic load and confirm their value for respiratory infection management.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Respiratory Tract Infections
/
Respiratory Syncytial Virus, Human
/
Respiratory Syncytial Virus Infections
/
Influenza, Human
Type of study:
Diagnostic study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
/
Infant
Language:
English
Journal:
J Antimicrob Chemother
Year:
2021
Document Type:
Article
Affiliation country:
Jac
Similar
MEDLINE
...
LILACS
LIS