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Research article
Yannick Mayamba NLANDU
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6158-0799
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: In symptomatic patients, the diagnostic approach of Covid-19 should be holistic. We aimed to evaluate the concordance between RT-PCR and serological tests (IgM/IgG), and identify the factors that best predict mortality (clinical stages or viral load).
Methods: The study included 242 patients referred to the University hospital of Kinshasa for suspected Covid-19, dyspnea or ARDS between June 1st, 2020 and August 02, 2020. Both antibody-SARS-CoV2 IgM/IgG and RT-PCR method were performed on the day of admission to hospital. The clinical stages were established according to the Covid-19 WHO classification. The viral load was expressed by the CtN2 (cycle threshold value of the nucleoproteins) and the CtE (envelope) genes of SARS- CoV-2 detected using GeneXpert. Kappa test and Cox regression were used as appropriate.
Results: The GeneXpert was positive in 74 patients (30.6%). Seventy two patients (29.8%) had positive IgM and 34 patients (14.0 %) had positive IgG. The combination of RT-PCR and serological tests made it possible to treat 104 patients as having Covid-19, which represented an increase in cases of around 41% compared to the result based on GeneXpert alone. The comparison between the two tests has shown that 57 patients (23.5 %) had discordant results. The Kappa coefficient was 0.451 (p <0.001). We recorded 23 deaths (22.1 %) among the Covid-19 patients vs 8 deaths (5.8 %) among other patients. The severe-critical clinical stage increased the risk of mortality vs. mild-moderate stage (aHR: 26.8, p < 0.001). The values of CtE and CtN2 did not influence mortality significantly.
Conclusion: in symptomatic patients, serological tests are a support which makes it possible to treat a greater number of Covid-19 patients. WHO Clinical classification seems to predict mortality better than SARS-Cov2 viral load.
Keywords
Covid-19, Symptomatic patients, Serological tests, RT-PCR, Concordance, Mortality
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View the published article at BMC Infectious Diseases.
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A new preprint design is coming!
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See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yannick Mayamba NLANDU
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6158-0799
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
Version 1
Posted 22 Dec, 2020
No community comments so far
Reviewer #1 agreed
On 09 May, 2021
Reviewers invited
Invitations sent on 18 Jan, 2021
Editor assigned
On 06 Jan, 2021
Submission checks complete
On 19 Dec, 2020
Editor invited
On 17 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background: In symptomatic patients, the diagnostic approach of Covid-19 should be holistic. We aimed to evaluate the concordance between RT-PCR and serological tests (IgM/IgG), and identify the factors that best predict mortality (clinical stages or viral load).
Methods: The study included 242 patients referred to the University hospital of Kinshasa for suspected Covid-19, dyspnea or ARDS between June 1st, 2020 and August 02, 2020. Both antibody-SARS-CoV2 IgM/IgG and RT-PCR method were performed on the day of admission to hospital. The clinical stages were established according to the Covid-19 WHO classification. The viral load was expressed by the CtN2 (cycle threshold value of the nucleoproteins) and the CtE (envelope) genes of SARS- CoV-2 detected using GeneXpert. Kappa test and Cox regression were used as appropriate.
Results: The GeneXpert was positive in 74 patients (30.6%). Seventy two patients (29.8%) had positive IgM and 34 patients (14.0 %) had positive IgG. The combination of RT-PCR and serological tests made it possible to treat 104 patients as having Covid-19, which represented an increase in cases of around 41% compared to the result based on GeneXpert alone. The comparison between the two tests has shown that 57 patients (23.5 %) had discordant results. The Kappa coefficient was 0.451 (p <0.001). We recorded 23 deaths (22.1 %) among the Covid-19 patients vs 8 deaths (5.8 %) among other patients. The severe-critical clinical stage increased the risk of mortality vs. mild-moderate stage (aHR: 26.8, p < 0.001). The values of CtE and CtN2 did not influence mortality significantly.
Conclusion: in symptomatic patients, serological tests are a support which makes it possible to treat a greater number of Covid-19 patients. WHO Clinical classification seems to predict mortality better than SARS-Cov2 viral load.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Figure 8
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