ISSN: 0973-7510

E-ISSN: 2581-690X

Research Article | Open Access
Jagadish Joshi1 , Om Prakash Joshi1, Sher Bahadur Kamar2, Guna Raj Awasthi1, Yogendra Shah2,3, Ramesh Shahi2, Sandip Khadka3, Hem Raj Joshi1, Pushpa Raj Padhaya1, Chet Raj Joshi4, Ram Prashad Ojha3, Sunil Bahadur Singh3, Lok Raj Bhatt3, Ram Singh Dhami5, Kishor Pandey5,6, Sudip Regmi7, Sita Ram Sapkota8, Dhan Kumar Pant9, Kamal Singh Khadka5, Shyam Prakash Dumre10 and Basu Dev Pandey5,11
1Health Directorate, Sudurpaschim Province, Rajpur, Doti, Nepal.
2Seti Provincial Hospital, Dhangadhi, Kailali, Nepal.
3Province Public Health Laboratory, Rajpur, Kailali, Nepal.
4Ministry of Social Development, Sudurpaschim Province, Dhangadhi, Kailali, Nepal.
5Everest International Clinic and Research Center, Kathmandu, Nepal.
6Central Department of Zoology, Tribhuvan University, Kathmandu, Nepal.
7Himalayan Essence Pvt. Ltd., Kathmandu, Nepal.
8Flinders University, Adelaide, Australia.
9National One Health Alliance for Nepal, Tahachal, Kathmandu, Nepal.
10Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.
11DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki, Japan.
Article Number: 8689 | © The Author(s). 2024
J Pure Appl Microbiol. 2024;18(1):662-671.
Received: 09 July 2023 | Accepted: 27 November 2023 | Published online: 02 March 2024
Issue online: March 2024

COVID-19 pandemic due to SARS-CoV-2 has been one of the major global health issues of this aeon. The aim of this study was to evaluate the association of SARS-CoV-2 cycle threshold (Ct) values with multiple factors among COVID-19 patients visiting a tertiary care hospital in Sudurpashchim province of Nepal. A retrospective analysis was performed on the data of randomly selected COVID-19 cases among the total RT-qPCR tested patients from March 2020 to April 2022. The Ct values at the time of patient admission and their clinical outcomes (discharge or death) were compared. Among the COVID-19 patients, survivor group had significantly higher initial Ct value compared to non-survivors [median Ct values 23.21 and 24.39 (P < 0.0001)]. Selected haematological parameters; white blood cells (P<001), neutrophils (P<001), and monocytes (P<0.0001), and all the biochemical parameters were significantly different between these two groups (p < 0.005). Furthermore, significantly increased CRP (61.54±63.00, P<0.0017), D-dimer levels (0.8979± 1.480, P<0.0001), creatinine (0.7931±0.2551, P<0.0001), monocytes (0.6782±0.7981, P<0.0001), and random blood sugar (152.4±34.32, P<0.0001) were observed among non-survivors indicating as cause of disease severity in COVID-19. The findings of this study imply that the Ct value, CRP and D-dimer levels could be a crucial marker for the early detection of severe COVID-19 patients or those at higher risk of developing severe disease. This will eventually help to identify cases requiring immediate and critical medical care and reduce mortality.


SARS-CoV-2, COVID-19, RT-qPCR, Cycle Threshold-Ct, Disease Severity, Severity Marker, Nepal

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© The Author(s) 2024. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.