Cycle Threshold to Test Positivity in COVID-19 for Return to Work Clearance in Health Care Workers

Abstract: 

Objective: To ascertain whether reverse transcriptase polymerase chain reaction (RT-PCR) cycle amplifications until detection, the cycle threshold (Ct), could help inform return to work (RTW) strategies for health care workers (HCWs) recovering from COVID-19 infection.

Methods: Sequential Ct data from COVID-19 nasal pharyngeal (NP) RT-PCR testing in all COVID-19 positive HCWs at a single institution. Analysis of Ct in relation to time until negative testing for RTW clearance.

Results: Data for 12 employees showed that time elapsed until RT-PCR test-based RTW clearance ranged from 7 to 57 days (median, 34.5 days). Lower initial Ct correlated with the total time elapsed until clearance (r = -0.80; P = 0.002).

Conclusion: Considering the RT-PCR Ct, which correlates with the estimated viral load, may help inform RTW planning and decision making beyond solely relying on dichotomized positive/negative results.

Author: 
Sandra Domeracki, RN, MSN, FNP-BC, COHN-S, FAAOHN
Robert N Clapp
Kristopher Taylor
Chuanyi M Lu
Harry Lampiris
Paul D Blanc
Publication date: 
November 1, 2020
Publication type: 
Journal Articles
Citation: 
Domeracki S, Clapp RN, Taylor K, Lu CM, Lampiris H, Blanc PD. Cycle Threshold to Test Positivity in COVID-19 for Return to Work Clearance in Health Care Workers. J Occup Environ Med. 2020 Nov;62(11):889-891. doi: 10.1097/JOM.0000000000001996. PMID: 32804748.