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Exploring the Relationship Between Comorbidities and Prolonged Viral Shedding in COVID-19: A Cycle Threshold
Rudi Wisaksana1, Patrick Philo2, Floriyani Indra Putri2
1Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
Purpose:
We aim to investigate which of the comorbidities is associated with prolonged viral RNA shedding among hospitalized patients with COVID-19 illness.
Patients And Methods:
We conducted a retrospective cohort study of COVID-19 patients in Hasan Sadikin General Hospital, Bandung, from March 2020 to April 2022. Data of ORF1b Ct value measurements were collected from the 1st week to the 5th week and presented in a line plot to see the changes in the Ct values across the course of the disease stratified to each comorbidity.
Results:
We included a total of 279 patients with a median age of 55-year-old, and male patients were the majority included. However, 68% of the original cohort was excluded due to having only a single Ct result. Based on the ORF1b Ct value data, most patients within each comorbidity group demonstrated increasing Ct values from Week 1 (n = 135) to Week 5 (n = 34). However, we found that the ORF1b Ct value in the HIV-AIDS (n = 12) and the autoimmune (n = 12) groups peaked and gradually declined. In the HIV-AIDS ORF1b, Ct values declined after 2 weeks (n = 2) with a statistically significant difference compared to patients without comorbidity (n = 65).
Conclusion:
This study shows that COVID-19 patients with HIV-AIDS have prolonged viral shedding compared to patients with other comorbidities.
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