1.Association of reverse transcription polymerase chain reaction (RT-PCR) cycle threshold (Ct) value on the incidence of cerebrovascular disease (CVD) in COVID-19 confirmed patients of Las Piñas General Hospital and Satellite Trauma Center (LPGH-STC): A case-control study
Kevin Dulce De Leon ; Rhoda Zyra Padilla-Baraoidan ; Karen Hernandez-Fortes
Philippine Journal of Internal Medicine 2025;63(1):30-38
OBJECTIVES
The study aimed to define the cycle threshold (Ct) value of reverse transcription polymerase reaction (RT PCR) as a potential marker in identifying the risk of COVID-19-confirmed patients in developing cerebrovascular disease (CVD) and to present the risk factors associated with such occurrence.
METHODSThe researcher employed a single center, retrospective, chart review, case-control study among adult RT-PCR confirmed, hospitalized COVID-19 patients at Las Piñas General Hospital and Satellite Trauma Center (LPGH STC) from January to December 2021. The study included 252 patients among 730 RT-PCR-confirmed adult COVID-19 patients who met the study population criteria.
RESULTSFifty patients had concomitant CVD, while 202 patients were non-CVD. The majority (n=143, 56.75%) were 19-59 years old male predominance (n=138, 54.76%). More than half of the study population suffered from either hypertension, diabetes, or both, with a high proportion of the subjects being non-compliant or no maintenance medications. Two hundred ten (83.3%) out of 252 patients were unvaccinated. Twenty (7.9%) patients were noted with a history of smoking, and 58 (23%) patients with a history of alcohol intake. The majority of the patients suffered moderate COVID-19 severity during their hospital stay, with a 30.16% (n=76) mortality rate. Ischemic stroke was the most common CVD, with 38 (76%) occurrences. Acute respiratory failure was the leading cause of death, followed by ARDS, brainstem failure, and ACS. The median cycle threshold among CVD patients was 32.84, significantly higher than the majority at 28.64. A higher mean Ct value was noted among patients with CVD infarct at 33.44 as compared to 26.83 among patients with Hemorrhagic Stroke. Utilizing the Point-Biserial Correlation Coefficient to analyze possible association between the Ct value and the occurrence of stroke, a 0.22 correlation coefficient implied a weak positive correlation between the Ct value and CVD occurrence.
CONCLUSIONThe relationship between the cycle threshold (Ct) value and the occurrence of CVD exists weakly, and factors that might affect this relationship must be addressed and resolved. Interpreting Ct value results also requires clinical context; hence, careful utilization of such data must always be observed. Several factors, including old age, male gender, co existing comorbidities such as hypertension and diabetes mellitus, lack of maintenance medication and noncompliance, vaccination status, smoking, and alcohol intake history, contributed to the poorer outcome of the patients and the high probability of having a stroke.
Human ; Covid-19 ; Cerebrovascular Diseases ; Cerebrovascular Disorders

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