Application of Ct value of nucleic acid testing in the construction of COVID?19 severe risk prediction model
Objective To investigate the prognostic value of Ct values from fluorescence PCR in COVID⁃19 severity assessment and to construct a severity risk prediction model integrating Ct values with bio⁃chemical markers.Methods A retrospective study was conducted on 236 COVID⁃19 hospitalized patients from Weihai Municipal Hospital affiliated with Shandong University from December 2022 to May 2023.Ct values and routine laboratory parameters were collected and logistic regression was utilized to identify factors influenc⁃ing the risk of severity,aiding in the creation of a prediction model.The model's effectiveness was assessed by plotting the receiver operating characteristic(ROC)curve and the Clinical Decision Curve Analysis(DCA),as well as quantifying contribution of the Ct values.Results The increase in age,white blood cell count,plate⁃lets,and hemoglobin as well as the decrease in Ct value,showed positive correlations with a higher risk of se⁃vere COVID⁃19.The COVID⁃19 severe pneumonia risk prediction model suggests that older patients with higher PLT and WBC levels,and Ct and HGB values,have a significantly increased risk of exacerbation.The model demonstrated strong fitness,as indicated by an AIC of 126.00,a C⁃index of 0.90,an R2 of 0.51 and an HL⁃test P⁃value of 0.53.The model incorporating Ct values outperformed the clinical⁃only model,showing im⁃proved AUC,sensitivity and specificity from 0.84 to 0.93,0.71 to 0.86,0.78 to 1.00 in the training set,and from 0.89 to 0.97,0.82 to 0.87,0.87 to 0.92 in the validation set,respectively.The DCA demonstrated the model's superior clinical utility.Conclusion Ct values are important for assessing the risk of severe COVID⁃19.The established model provides an efficacious early diagnostic and therapeutic tool.
SARS-CoV-2COVID-19CtSevere disease riskPrediction model
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