Cochrane COVID-19 Study Register
Gaston 2020a

Clinical implications of SARS-CoV-2 cycle threshold values in solid organ transplant recipients

  1. Study Type
  2. Observational
  1. Study Aim
  2. Diagnostic/Prognostic
  1. Study Design
  2. Case series/Case control/Cohort
  1. Intervention Assignment
  2. Not Applicable

Clinical implications of SARS-CoV-2 cycle threshold values in solid organ transplant recipients

Gaston DC, Malinis M, Osborn R, Peaper DR, Landry M, Juthani-Mehta M, Azar MM
Journal article
Report Results
Detection of SARS-CoV-2 viral RNA by RT-PCR assays is the primary diagnostic test for COVID-19. Cycle threshold (CT ) values generated by some of these assays provide inversely proportional proxy measurements of viral load. The clinical implications of CT values are incompletely characterized, particularly in solid organ transplant (SOT) recipients. We conducted a retrospective chart review of 25 adult SOT recipients admitted to the Yale New Haven Health System between March 1 - May 15, 2020, analyzing 50 test results to investigate clinical implications of SARS-CoV-2 CT values in this population. Initial CT values from upper respiratory tract samples were significantly higher in patients on tacrolimus, but were not associated with admission severity nor highest clinical acuity. Viral RNA was detected up to 38 days from symptom onset with a gradual increase in CT values over time. In 5 patients with serial testing, CT values <35.0 were detected >21 days after symptom onset in 4/5 and ≥27 days in 2/5, demonstrating prolonged RNA detection. These data describe SARS-CoV-2 viral dynamics in SOT patients and suggest that CT values may not be useful to predict COVID-19 severity in SOT patients. SARS-CoV-2 CT values may be more useful in informing infection prevention measures
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