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Makulo JR, Mandina MN, Mbala PK, Wumba RD, Akilimali PZ, Nlandu YM, Odio JO, Bepouka BI, Longokolo MM, Mukenge EK, Kamwiziku G, Muamba JM, Longo AL, Lufu CM, Keke HL, Mbula MM, Situakibanza HN, Sumaili EK, Kayembe JMN. SARS-CoV2 infection in symptomatic patients: interest of serological tests and predictors of mortality: experience of DR Congo. BMC Infect Dis 2022; 22:21. [PMID: 34983411 PMCID: PMC8724652 DOI: 10.1186/s12879-021-07003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/22/2021] [Indexed: 01/08/2023] Open
Abstract
Background In symptomatic patients, the diagnostic approach of COVID-19 should be holistic. We aimed to evaluate the concordance between RT-PCR and serological tests (IgM/IgG), and identify the factors that best predict mortality (clinical stages or viral load).
Methods The study included 242 patients referred to the University hospital of Kinshasa for suspected COVID-19, dyspnea or ARDS between June 1st, 2020 and August 02, 2020. Both antibody-SARS-CoV2 IgM/IgG and RT-PCR method were performed on the day of admission to hospital. The clinical stages were established according to the COVID-19 WHO classification. The viral load was expressed by the CtN2 (cycle threshold value of the nucleoproteins) and the CtE (envelope) genes of SARS- CoV-2 detected using GeneXpert. Kappa test and Cox regression were used as appropriate.
Results The GeneXpert was positive in 74 patients (30.6%). Seventy two patients (29.8%) had positive IgM and 34 patients (14.0%) had positive IgG. The combination of RT-PCR and serological tests made it possible to treat 104 patients as having COVID-19, which represented an increase in cases of around 41% compared to the result based on GeneXpert alone. The comparison between the two tests has shown that 57 patients (23.5%) had discordant results. The Kappa coefficient was 0.451 (p < 0.001). We recorded 23 deaths (22.1%) among the COVID-19 patients vs 8 deaths (5.8%) among other patients. The severe-critical clinical stage increased the risk of mortality vs. mild-moderate stage (aHR: 26.8, p < 0.001). The values of CtE and CtN2 did not influence mortality significantly. Conclusion In symptomatic patients, serological tests are a support which makes it possible to refer patients to the dedicated COVID-19 units and treat a greater number of COVID-19 patients. WHO Clinical classification seems to predict mortality better than SARS-Cov2 viral load.
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Affiliation(s)
- Jean-Robert Makulo
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Madone Ndona Mandina
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Placide Kingebeni Mbala
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.,Secrétariat Technique du Comité Multisectoriel de la Riposte Contre la Covid-19, Kinshasa, Democratic Republic of the Congo
| | - Roger Dimosi Wumba
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Pierre Zalagile Akilimali
- Ecole de Santé Publique, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Yannick Mayamba Nlandu
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.
| | - Jerome Ossam Odio
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ben Izizag Bepouka
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Murielle Mashi Longokolo
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Eric Kasongo Mukenge
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Guyguy Kamwiziku
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jonathan Mutombo Muamba
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Augustin Luzayadio Longo
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Crispin Muanza Lufu
- Secrétariat Technique du Comité Multisectoriel de la Riposte Contre la Covid-19, Kinshasa, Democratic Republic of the Congo
| | - Hervé Letin Keke
- Secrétariat Technique du Comité Multisectoriel de la Riposte Contre la Covid-19, Kinshasa, Democratic Republic of the Congo
| | - Marcel Mambimbi Mbula
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hippolyte Nanituma Situakibanza
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ernest Kiswaya Sumaili
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Marie Ntuma Kayembe
- Cliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.,Secrétariat Technique du Comité Multisectoriel de la Riposte Contre la Covid-19, Kinshasa, Democratic Republic of the Congo
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