head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2022, vol. 28, issue2
Subject Area: Medicine
DOI: 10.5272/jimab.2022282.4409
Published online: 15 June 2022

Original article
J of IMAB. 2022 Apr-Jun;28(2):4409-4417
Mariya Sredkova1ORCID logo Corresponding Autoremail, Cvetan Popov1ORCID logo, Georgi Golemanov1ORCID logo, Pencho Tonchev2ORCID logo, Vladislav Nankov1ORCID logo, Alexander Blazhev1ORCID logo, Antoniya Popova1ORCID logo, Radostina Mogilska1ORCID logo, Valeri Delcheva1ORCID logo, Eleonora Kuteva1ORCID logo,
1) Virology Laboratory, Institute of Science and Research, Medical University, Pleven, Bulgaria.
2) Department of Surgical Nursing, Faculty of Health Care, Medical University, Pleven, Bulgaria.

Purpose: To describe clinical characteristics of patients positive simultaneously for RdRp, N and E genes of SARS-CoV-2 and to analyse dynamics of symptoms and Ct values in the interval from day 0 to day 10 after symptoms onset.
Materials and methods: Retrospective analysis of data obtained on the day of specimen collection from 1044 individuals was carried out. Detection of RdRp, E and N genes of SARS-CoV-2 was conducted by RT-PCR. Only patients positive for all three genes were included.
Results: Out of all patients, 47.8% were female, and 52.2% were male with a median age of 60 years, and the elder (>50 years) population constituted 71.5%. The most common comorbidities were cardiovascular disease (44.5%), diabetes mellitus (11.0%), and chronic pulmonary disease (8.6%). The prevalent symptoms at the time of specimen collection were fever (74.7%), cough (67.1%), and dyspnea (39.6%). Fever and cough were leading symptoms in the time interval between zero and the tenth day since the onset of COVID-19. A linear trend for dry cough and dyspnea, with a daily increase of 2.2% and 2.3%, respectively, was observed. Dry cough was the primary discriminator in distinguishing mild and moderate infection. Gradual increase of Ct values of all genes was observed from day 0 to day 10, and day 3 was essential for separating two time intervals.
Conclusions: Flu-like symptoms were leading over the study period. Male sex, older age, cardiovascular disease, diabetes mellitus, and chronic pulmonary disease were risk factors for infection. Cough, age over 65 years and male sex in the group 33-63 years were predictors of more severe disease.

Keywords: COVID-19, symptoms, dynamics, RT-PCR, Ct values,

pdf - Download FULL TEXT /PDF 1903 KB/
Please cite this article as: Sredkova M, Popov C, Golemanov G, Tonchev P, Nankov V, Blazhev A, Popova A, Mogilska R, Delcheva V, Kuteva E. Dynamics of COVID-19 Symptoms and Changes in Ct Values of RdRp, N and E genes in 1044 Patients Positive for SARS-CoV-2. J of IMAB. 2022 Jan-Mar;28(1):4409-4417. DOI: 10.5272/jimab.2022282.4409

Corresponding AutorCorrespondence to: Mariya Petrova Sredkova, Virology Laboratory, Institute of Science and Research, Medical University – Pleven; 1, St. Kliment Ohridski Str., Pleven, Bulgaria; E-mail: microvir@abv.bg

1. Wu Z, Mcgoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-42. [PubMed]
2. Cao Y, Liu X, Xiong L, Cai K. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2: A systematic review and meta-analysis. J Med Virol. 2020 Sep;92(9):1449-59. [PubMed]
3. Larsen JR, Martin MR, Martin JD, Kuhn P, Hicks JB. Modeling the Onset of Symptoms of COVID-19. Front Public Health. 2020 8:473. [PubMed]
4. Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q, et al. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. BMJ. 2020 Apr 21;369:m1443. [PubMed]
5. Ra SH, Lim JS, Kim GU, Kim MJ, Jung J, Kim SH. Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection. Thorax. 2021 Jan;76(1):61-3. [PubMed]
6. Who. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. World Health Organization. 2020 12 January 2020; 10. 
7. Halalau A, Odish F, Imam Z, Sharrak A, Brickner E, Lee PB, et al. Epidemiology, Clinical Characteristics, and Outcomes of a Large Cohort of COVID-19 Outpatients in Michigan. Int J Gen Med. 2021; 14:1555-63. [PubMed]
8. Li J, Huang DQ, Zou B, Yang H, Hui WZ, Rui F, et al. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. J Med Virol. 2021 Mar;93(3):1449-58. [PubMed]
9. Lechien JR, Chiesa-Estomba CM, Place S, Van Laethem Y, Cabaraux P, Mat Q, et al. Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019. J Intern Med. 2020 Sep; 288(3): 335-44. [PubMed]
10. Eythorsson E, Helgason D, Ingvarsson RF, Bjornsson HK, Olafsdottir LB, Bjarnadottir V, et al. Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study. BMJ. 2020 Dec 2;371:m4529. [PubMed]
11. Speth MM, Singer-Cornelius T, Oberle M, Gengler I, Brockmeier SJ, Sedaghat AR. Olfactory Dysfunction and Sinonasal Symptomatology in COVID-19: Prevalence, Severity, Timing, and Associated Characteristics. Otolaryngol Head Neck Surg. 2020 Jul;163(1):114-20. [PubMed]
12. Lal P, Chamoli P, Tuli IP, Jaitly S, Sneha SN, Sharma S, et al. Olfactory and Gustatory Dysfunctions in Patients With Laboratory-Confirmed COVID-19 Infection: A Change in the Trend. Indian J Otolaryngol Head Neck Surg. 2021 Jul 18:1-7. [PubMed]
13. Lechien JR, Chiesa-Estomba CM, Vaira LA, De Riu G, Cammaroto G, Chekkoury-Idrissi Y, et al. Epidemiological, otolaryngological, olfactory and gustatory outcomes according to the severity of COVID-19: a study of 2579 patients. Eur Arch Otorhinolaryngol. 2021 Aug;278(8):2851-9. [PubMed]
14. Von Bartheld CS, Hagen MM, Butowt R. Prevalence of Chemosensory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis Reveals Significant Ethnic Differences. ACS Chem Neurosci. 2020 Oct 7; 11(19):2944-61. [PubMed]
15. Mendonca CV, Mendes Neto JA, Suzuki FA, Orth MS, Machado Neto H, Nacif SR. Olfactory dysfunction in COVID-19: a marker of good prognosis? Braz J Otorhinolaryngol. 2021 Jan 1; [PubMed]
16. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020 Mar 19;382(12):1177-9. [PubMed]
17. Wolfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Muller MA, et al. Virological assessment of hospitalized patients with COVID-2019. Nature, 2020 May;581(7809):465-9. [PubMed]
18. Sangineto M, Arena F, De Nittis R, Villani R, Gallo C, Serviddio G. Temporal profile of SARS-CoV-2 viral load in posterior nasopharyngeal samples: Analysis of 944 patients in Apulia, Italy. Int J Infect Dis. 2021 Mar;104:696-700. [PubMed]
19. V’kovski P, Kratzel A, Steiner S, Stalder H, Thiel V. Coronavirus biology and replication: implications for SARS-CoV-2. Nat Rev Microbiol. 2021 Mar;19(3):155-70. [PubMed]
20. Subbarao K, Mahanty S. Respiratory Virus Infections: Understanding COVID-19. Immunity. 2020 Jun 16;52(6):905-9. [PubMed].

Received: 12 January 2022
Published online: 15 June 2022

back to Online Journal