COVID-19 HASTALARINDA UZAMIŞ RT-PCR POZİTİFLİĞİ VE VİRAL YÜKÜN DEĞERLENDİRİLMESİ

Öz

Amaç: COVID-19 tanısında gerçek-zamanlı polimeraz zincir reaksiyonu (RT-PCR) testi kullanılmakta olup çalışmamızda; viral konversiyon süresini etkileyen faktörlerin ve bunların viral yük ile ilişkisinin incelenmesi, ayrıca viral yükü etkileyebilecek diğer faktörlerin irdelenmesi amaçlanmıştır. Metod: Hastanemizde 15.03.2020-01.08.2020 tarihleri arasında hospitalize edilmiş ve viral konversiyon saptanmış hastalar retrospektif olarak tarandı. Hastalar viral konversiyon süresine göre iki gruba ayrıldı (0-14 gün ve >14 gün). Bulgular: Çalışmaya viral konversiyon süresi 0-14 gün olan 284 hasta ve >14 gün olan 65 hasta olmak üzere toplam 349 hasta dahil edildi. Hastaların yaş ve cinsiyet özellikleri benzer olarak saptandı. Uzamış PCR pozitifliği olan grupta daha fazla ölüm (p=0.036) ve daha düşük döngü eşiği (Cycle-treshold- CT) değeri (p=0.017) saptandı. 18’inde mortalite nedeniyle viral konversiyonun değerlendirilemediği toplam 246 hastanın CT değerinin incelemesinde 60 yaş üzerinde (p=0.006), kardiyovasküler sistem hastalığı varlığında (p<0.001) ve ölen hastalarda (p<0.001) CT değeri daha düşük, dolayısıyla viral yük daha yüksek saptandı. Sonuç: Uzamış PCR pozitifliği viral yük artışını ve olumsuz sonuçlarla ilişkili olabilir. Hastanın yaşı, CT değeri, komorbid durumları ve viral konversiyon süresini içeren bir değerlendirme progroz hakkında fikir verebilir.

Anahtar Kelimeler

• Klerens
• döngü-eşiği (CT) değeri
• negatif konversiyon
• SARS-CoV-2
• viral yük

Evaluation of Prolonged Rt-Pcr Positivity and Viral Load in COVID-19 Patients

Abstract

Aim: Real-time reverse transcription polymerase chain reaction (RT-PCR) test is used in the diagnosis of COVID-19. It was aimed to evaluate the factors affecting the viral conversion time, to examine the relationship between viral load, and to determine other factors that may be associated with viral load. Material and Methods: Patients were hospitalized between 15.03.2020-01.08.2020, and viral conversion detected were evaluated retrospectively. Patients were divided into two according to viral conversion time (0-14 days vs >14 days). Results: 349 patients were included in the study (284 vs 65 patients). The age and gender characteristics were similar. Prolonged PCR positivity group had more death (p=0.036) and lower cycle-threshold (CT) value (p=0.017). In the examination of CT values of 246 patients, 228 patients with viral conversion and 18 patients without viral conversion due to death, the CT value was found to be lower, therefore the viral load was higher in patients over 60 years of age (p=0.006), in the presence of cardiovascular system disease (p<0.001) and in patients who died (p<0.001). Conclusion: Prolonged PCR positivity may indicate excess viral load and adverse outcomes. An evaluation including the patient's age, CT value, comorbid conditions, and viral conversion time can give an idea about the prognosis.

Keywords

• Clearance
• cycle threshold (CT) value
• negative conversion
• SARS‐CoV‐2
• viral load

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