Background: SARS-CoV-2 RT-PCR cycle threshold (Ct) values have been proposed as a surrogate for viral burden, while C-reactive protein (CRP) reflects systemic inflammation. Their utility for prognostication in hospitalized patients with COVID-19 pneumonitis remains uncertain.

Methods: This retrospective observational study included 154 adults with symptomatic moderate-to-severe COVID-19 pneumonitis presenting to the Emergency Department of Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute between 1 March 2020 and 15 March 2021. Demographic variables, symptom duration, oxygen saturation, CRP, Ct value, comorbidities, ICU duration, duration of mechanical ventilation, and outcome were analyzed. The median Ct value of 22 was used to compare outcome groups, and correlations were assessed using Pearson correlation and appropriate comparative statistical tests.

Results: The mean age was 60.4 years and 69% of patients were male. The mean CRP was 12.71 mg/dL and mean Ct value was 22.51 ± 4.30. ICU admission was required in 148 patients; 62 required intubation and 46 patients died. Ct value was not significantly associated with ICU duration (p =0.27), need for intubation (p =0.39), duration of intubation (p =0.96), or mortality (p =0.67). No significant correlation was observed between CRP and Ct value in the overall cohort (r=-0.0377, p =0.64), among patients with symptoms >5 days (r=0.019, p =0.864), or among patients requiring ICU admission (r=-0.0626, p =0.61). Multiple comorbidities were associated with significantly higher ICU duration, ventilator duration, and mortality.