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SARS CoV 2 Laboratory Diagnosis

Yıl 2020, , 76 - 84, 30.04.2020
https://doi.org/10.34084/bshr.726126

Öz

World Health Organization (WHO) named the disease caused by SARS-CoV-2 coronavirus on 11 February 2020 as coronavirus disease-2019 (Coronavirus disease-19 - COVID-19). A person with a fever, sore throat, cough and shortness of breath and a history of contact with a patient with confirmed COVID-19 infection is identified as a possible case and is expected to be confirmed by laboratory tests. A confirmed case is a suspected condition with a positive molecular test. The cases can be asymptomatic or fever-free.
Specific diagnosis is made by specific molecular tests with respiratory samples (orafarengeal / nasopharyngeal swab / sputum / endotracheal aspirates and bronchoalveolar lavage ..). The virus can also be detected in the stool and in severe cases for a short time in the blood. Currently validated and certified tests not common. However, the molecular tests that should be used in the case of a pandemic are rapidly increasing. Early in the case of a suspected outbreak reported in Turkey, just before the first tests carried out in the central unit has been expanded to more appropriate designated reference laboratory. Rapid antigen tests did not provide the desired performance, while rapid antibody tests were distributed to the field to support PCR tests and determine immunity.
Laboratories are indispensable in controlling the COVID-19 pandemic. Molecular testing has become widespread in our country recently, the number of daily tests has increased, the results have become rapid, and laboratory support has been provided to the clinic and fillation.

Kaynakça

  • 1. Zhu N, Zheng D, Wang W, Xingwang L, Yang B, Song J, et al. . A novel coronavirus from patients with pneumonia in China, 2019. New Engl J Med 2020;382(8):727–733.
  • 2. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395(10224): 565–574.
  • 3. Gorbalenya AE, Baker SC, Babic RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. Severe acute respiratory syndrome-related coronavirus: the species and its viruses—a statement of the Coronavirus Study Group. bioRxiv 2020. doi:10.1101/2020.02.07.937862.
  • 4. Peeri NC, Shrestha N, Rahman MS, Zaki R, Tan Z, Bibi S et al. The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? Int J Epidemiol., 2020.
  • 5. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it Erişim tarihi: 28 Mart 2020
  • 6. Patel R, Babady E, Theel ES, Storch GA, Pinsky BA, St George K, Smith TC, Bertuzzi S. Report from the American Society for Microbiology COVID-19 International Summit, 23 March 2020: Value of Diagnostic Testing for SARS-CoV-2/COVID-19. mBio. 2020; 26;11(2). pii: e00722-20.
  • 7. Patel R, Fang FC. 2018. Diagnostic stewardship: opportunity for a laboratory-infectious diseases partnership. Clin Infect Dis 67:799–801.
  • 8. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q, Song T, He J, Yen H-L, Peiris M, Wu J. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020; 382:1177–1179.
  • 9. Dhiman N, Miller RM, Finley JL, Sztajnkrycer MD, Nestler DM, Boggust AJ, Jenkins SM, Smith TF, Wilson JW, Cockerill FR, Pritt BS. Effectiveness of patient-collected swabs for influenza testing. Mayo Clin Proc 2012; 87: 548 –554.
  • 10. Winichakoon P, Chaiwarith R, Liwsrisakun C, Salee P, Goonna A, Limsukon A, Kaewpoowat Q. 26 February 2020. Negative nasopharyngeal and oropharyngeal swab does not rule out COVID-19. J Clin Microbiol. https://doi.org/10.1128/JCM.00297-20.
  • 11. Zhao J, Yuan Q, Wang H, et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. Clin Infect Dis. 2020 Mar 28. DOI 10.1093/cid/ciaa344. [Epub ahead of print]
  • 12. Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020; 11. doi:10.1001/jama.2020.3786
  • 13. Guo L1, Ren L1, Yang S2, et al. Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19). Clin Infect Dis. 2020 Mar 21. pii: ciaa310. doi: 10.1093/cid/ciaa310. [Epub ahead of print]
  • 14. Li Z, Yi Y, Luo X, et al. Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. J Med Virol. 2020. doi: 10.1002/jmv.25727. [Epub ahead of print].

SARS CoV 2 Laboratuvar Tanısı

Yıl 2020, , 76 - 84, 30.04.2020
https://doi.org/10.34084/bshr.726126

Öz

Dünya Sağlık Örgütü (DSÖ), 11 Şubat 2020’de SARS-CoV-2 koronavirüsün neden olduğu hastalığı koronavirus hastalığı-2019 (Coronavirus disease-19 - COVID-19) olarak adlandırmıştır. Ateşi, boğaz ağrısı, öksürüğü ve nefes darlığı olan ve COVID-19 enfeksiyonu doğrulanmış hasta ile temas öyküsü bulunan bir kişi olası vaka olarak tanımlanır ve laboratuvar testleri ile doğrulanması beklenir. Doğrulanmış bir vaka, pozitif bir moleküler teste sahip şüpheli bir durumdur. Vakalar asemptomatik veya ateşsiz de olabilir.
Spesifik tanı, solunum örnekleri ile spesifik moleküler testlerle yapılır(orafarenks / nazofaringeal swabı / balgam / endotrakeal aspiratlar ve bronkoalveoler lavaj..). Virüs dışkıda ve ciddi vakalarda kanda da kısa süre için saptanabilmektedir. Şu anda mevcut olan sendromik multipleks PCR panellerinin COVID-19'u içermediği unutulmamalıdır. Valide ve sertifikalı testlerde şu anda yaygın değildir. Ancak pandemi durumunda kullanılması gereken moleküler testlerde hızla artmaktadır. Türkiye'de salgının ilk dönemlerinde şüpheli bir olgu durumunda, ilk önce sadece merkezi birimlerde yapılan testler daha uygun belirlenmiş referans laboratuarlara yaygınlaştırılmıştır. Hızlı antijen testleri arzu edilen performansı sağlamamış, hızlı antikor testleri ise PCR testlerine destek olmak ve bağışıklığı belirlemek amacıyla sahaya dağıtılmıştır.
Diğer laboratuvar testleri genellikle spesifik değildir. Beyaz küre sayısı genellikle normal veya düşüktür. Lenfopeni olabilir; 1000'den az olan bir lenfosit sayısı ciddi hastalıklarla ilişkilendirilmiştir. Trombosit sayısı genellikle normal veya hafif derecede düşüktür. CRP ve ESR genellikle yükselir, prokalsitonin seviyeleri genellikle normal nadiren yüksektir. Yüksek bir prokalsitonin seviyesi, bakteriyel koenfeksiyonu gösterebilir. ALT / AST, protrombin zamanı, kreatinin, D-dimer, CPK ve LDH yüksek ve şiddetli hastalıklarla ilişkilidir.
Gerektiği şekilde çok miktarda test yapılmalı, testler yaygınlaştırılmalı, sonuçları hızlı verilmeli, kliniğe ve sahaya daha çok laboratuvar desteği sağlanmalıdır.

Kaynakça

  • 1. Zhu N, Zheng D, Wang W, Xingwang L, Yang B, Song J, et al. . A novel coronavirus from patients with pneumonia in China, 2019. New Engl J Med 2020;382(8):727–733.
  • 2. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395(10224): 565–574.
  • 3. Gorbalenya AE, Baker SC, Babic RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. Severe acute respiratory syndrome-related coronavirus: the species and its viruses—a statement of the Coronavirus Study Group. bioRxiv 2020. doi:10.1101/2020.02.07.937862.
  • 4. Peeri NC, Shrestha N, Rahman MS, Zaki R, Tan Z, Bibi S et al. The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? Int J Epidemiol., 2020.
  • 5. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it Erişim tarihi: 28 Mart 2020
  • 6. Patel R, Babady E, Theel ES, Storch GA, Pinsky BA, St George K, Smith TC, Bertuzzi S. Report from the American Society for Microbiology COVID-19 International Summit, 23 March 2020: Value of Diagnostic Testing for SARS-CoV-2/COVID-19. mBio. 2020; 26;11(2). pii: e00722-20.
  • 7. Patel R, Fang FC. 2018. Diagnostic stewardship: opportunity for a laboratory-infectious diseases partnership. Clin Infect Dis 67:799–801.
  • 8. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q, Song T, He J, Yen H-L, Peiris M, Wu J. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020; 382:1177–1179.
  • 9. Dhiman N, Miller RM, Finley JL, Sztajnkrycer MD, Nestler DM, Boggust AJ, Jenkins SM, Smith TF, Wilson JW, Cockerill FR, Pritt BS. Effectiveness of patient-collected swabs for influenza testing. Mayo Clin Proc 2012; 87: 548 –554.
  • 10. Winichakoon P, Chaiwarith R, Liwsrisakun C, Salee P, Goonna A, Limsukon A, Kaewpoowat Q. 26 February 2020. Negative nasopharyngeal and oropharyngeal swab does not rule out COVID-19. J Clin Microbiol. https://doi.org/10.1128/JCM.00297-20.
  • 11. Zhao J, Yuan Q, Wang H, et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. Clin Infect Dis. 2020 Mar 28. DOI 10.1093/cid/ciaa344. [Epub ahead of print]
  • 12. Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020; 11. doi:10.1001/jama.2020.3786
  • 13. Guo L1, Ren L1, Yang S2, et al. Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19). Clin Infect Dis. 2020 Mar 21. pii: ciaa310. doi: 10.1093/cid/ciaa310. [Epub ahead of print]
  • 14. Li Z, Yi Y, Luo X, et al. Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. J Med Virol. 2020. doi: 10.1002/jmv.25727. [Epub ahead of print].
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Viroloji
Bölüm Derleme
Yazarlar

Mustafa Altındiş 0000-0003-0411-9669

Hande Toptan 0000-0001-6893-8490

Yayımlanma Tarihi 30 Nisan 2020
Kabul Tarihi 28 Nisan 2020
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

AMA Altındiş M, Toptan H. SARS CoV 2 Laboratuvar Tanısı. J Biotechnol and Strategic Health Res. Nisan 2020;4:76-84. doi:10.34084/bshr.726126
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