COVID-19 Şüpheli Hastalarda Total Antikor Testlerinin Bilgisayarlı Tomografi ve Polimerize Zincir Reaksiyon Test Sonuçları ile Değerlendirmesi

Yıl 2023, , 1 - 6, 29.03.2023

Hacer İşler , Melek Bilgin Eşe Başbulut , Selim Görgün , Cemanur Aygün , Alper Tahmaz , Eda Köksal , Eylem Burcu Reşörlü Mirsad Yalçınkaya

https://doi.org/10.58854/jicm.1206881

Öz

Amaç: COVID-19’un erken tanımlanması, hastalık tedavisi ve yönetiminde çok önemlidir. Kanda spesifik antikorların tespitiyle solunum yolu örneklerinden kaynaklanan yanlış negatif sonuçların önüne geçilebilir. Çalışmada COVID-19 şüphesi olan hastaların nazofaringeal sürüntülerinden alınan Hızlı Antikor Testleri, Akciğer BT taramaları ve polimeraz zincir reaksiyonu testlerinin sonuçlarını değerlendirilmesi amaçlanmıştır.

Yöntem: 15.03.2020-15.06.2020 tarihleri arasında COVID-19 şüphesi olan hastalardan ve şikayeti olan sağlık çalışanlarından alınan venöz kan örnekleri, Hodget Card Hızlı Antikor Testi (IgM + IgG) ile SBU Samsun Eğitim ve Araştırma Hastanesi mikrobiyoloji laboratuvarımızda test edildi. Çalışmada 295 kişinin hızlı antikor testi yapıldı.

Bulgular: Hastaların yaş ortalaması 52±17,9 olup %55,4’ü erkekti. %39,3’ü poliklinikte, %39’u serviste, %19’u yoğun bakımda hastasıydı. Hızlı antikor testi yapılan 295 hastanın %56,6’sında PCR testinin pozitif çıktığı, %9,8’inde negatif olduğu, %33,6’sında PCR testi çalışılmadığı belirlendi.

Sonuç: Çalışmamızda toraks BT’nin COVID-19’u tanımlamada PCR’den duyarlı olduğu gösterildi. Altın standart olan PCR testi negatif kişilerde hızlı antikor testlerinin pozitifliği , antikor testinin, CT veya PCR testi ile gözden kaçan hastalarda hasta doğrulaması için yararlı olduğunu, PCR testinin antikor testleri ile kombine kullanılmasının gerekliliğini göstermiştir.

Anahtar Kelimeler

COVID-19, SARS CoV-2, Hızlı Antikor Testi, Toraks BT, PCR

Evaluation of Total Antibody Tests in Patients with Suspected COVID-19 by Computed Tomography and Polymerized Chain Reaction Test Results

Öz

Objective: Early identification of COVID-19 is crucial in disease treatment and management. False negative results from respiratory tract samples can be avoided by detecting specific antibodies in the blood. The aim of the study was to evaluate the results of Rapid Antibody Tests, Lung CT scans and polymerase chain reaction tests taken from nasopharyngeal swabs of patients with suspected COVID-19.

Methods: Venous blood samples taken from patients with suspected COVID-19 and healthcare workers with complaints between 15.03.2020 and 15.06.2020 were tested in our microbiology laboratory with Hodget Card Rapid Antibody Test (IgM + IgG) at SBU Samsun Training and Research Hospital. Rapid antibody testing was performed on 295 people in the study.

Results: The mean age of the patients was 52±17.9 years and 55.4% were male. 39.3% of them were in the outpatient clinic, 39% were in the service, and 19% were in the intensive care unit. It was determined that of 295 patients who underwent rapid antibody test, the PCR test was positive in 56.6%, negative in 9.8%, and no PCR test in 33.6%.

Conclusion: In our study, it was shown that thorax CT is more sensitive than PCR in identifying COVID-19. The positivity of rapid antibody tests in people with negative PCR testing, which is the gold standard, showed that antibody testing is useful for patient confirmation in patients missed by CT or PCR testing, and that PCR testing should be used in combination with antibody tests.

Anahtar Kelimeler

COVID-19, SARS CoV-2, Rapid Antibody Test, Thorax CT, RT-PCR

Kaynakça

• Chan JF, Yip CC to KK, Tang TH, Wong SC, Leung KH, et al. Enhanced molecular diagnosis of COVID-19 with new, high precision and specific COVID-19-RdRp / hel real-time reverse transcription-PCR assay validated with in vitro and clinical samples. J. Clin. Microbiol. 2020; 23: 58 10.1128 / JCM.00310-20.
• Scohy A, Anantharajah A, Bodéus M, Kabamba-Mukadi B, Verroken A ve Rodriguez-Villalobos H. Low performance of rapid antigen detection test as frontline testing for COVID-19 diagnosis. J Clin Virol.2020 Aug;129:104455.
• Johns Hopkins Üniversitesi’nde (JHU) Sistem Bilimi ve Mühendisliği Merkezi (CSSE) tarafından COVID-19 Kontrol Paneli: https:// coronavirus.jhu.edu/map.html.
• Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
• Casais R, Davies M, Cavanagh D, Britton P. Gene 5 of avian coronavirus infectious bronchitis virus is not required for replication. J Virol. 2005; 79: 8065-78.
• Current status, challenges, and countermeasures Yan Y et al. (Rev Med Vrol 2020;e2106; do: 10.1002/rmv.2106).
• Haijema BJ, Volders H, Rottier PJ. Through the directed deletion of group-specific genes, live attenuated coronavirus vaccines protect against feline infectious peritonitis. J Virol. 2004; 78: 3863-32.
• Ai T, Yang Z, Hou H, et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology, In Press (2020;xx:xx).
• Kubina R, Dziedzic A. Molecular and Serological Tests for COVID-19 a Comparative Review of SARS-CoV-2 Coronavirus Laboratory and Point-of-Care Diagnostics. Diagnostics (Basel). 2020 Jun 26;10(6):434.
• World Health Organization (WHO), Coronavirus disease (COVID-19) technical guidance:Laboratory testingfor2019- nCoV inhumans,Interimguidance. https://www. who.int/ publications-detail/laboratory testing-for-2019-novelcoronavirus insuspected-human-cases-20200117, 2020.
• Xiao S, Zhu B, Zhang M, Zhang T, Zheng Z, Xiang J. A sequential study of serum specific IgM antibody responses in patients with epidemic hemorrhagic fever and its relationship to the severity of illness. Chinese J Immunol. 1986;4:218-21.
• World Health Organisation (WHO) Coronavirus disease (COVID-19) Pandemic. Geneva: WHO 2020. Available at https:// www.who.int/emergencies/ diseases/ novel-coronavirus-2019. Accessed 1 April 2020.
• Corman VM, Landt O, Kaiser M, et al. Detection of 2019 novel coronavirus (2019- nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3).
• Foundation for Innovative New Diagnostics (FIND). SARS-2 Diagnostic Pipeline. Available at https:// www.finddx.org/covid-19/ pipeline. Accessed 1 April 2020.
• Ai T, Yang Z, HouH, Zhan C, ChenC, Lu W et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology, In Press.
• Cheng Z, Lu Y, Cao Q, Qin Le, Pan Z, Yan F et al. Clinical features and Chest CT manifestations of Coronavirus Disease 2019 (COVID-19) in a single-center study in Shanghai, China. AJR 2020; 215: 1-6.
• Lauer SA, Grantz KH, Bi Q., Jones FK, Zheng Q., Meredith HR, Azman AS, Reich NG, Lessler J. ve Uygulama. Ann. Stajyer. Med. 2020 .
• Rashid Z Z, Othman, Abdul Samat MN, Ali UK, Wong KK. Diagnostic performance of COVID-19 serology assays. Malays J Pathol. 2020;42(1):13-21.
• Abdollahi A, Salarvand S, Mehrtash V, Jafarzadeh B, Salehi M, Ghalehtaki R, Nateghi S. The Performance of SARS-CoV-2 Serology Testing in the Diagnosis of COVID-Iran J Pathol. 2022 Winter;17(1):65-70. 20.
• Soeorg H, Jõgi P, Naaber P, Ottas A, Toompere K, Lutsar I. Seroprevalence and levels of IgG antibodies after COVID-19 infection or vaccination. Infect Dis (Lond). 2022 ;54(1):63-71.
• Buntinx F, Claes P, Gulikers M, Verbakel J, Jan L, Van der Elst M, Van Elslande J, Van Ranst M, Vermeersch P. Added value of anti-SARS CoV-2 antibody testing in a Flemish nursing home during an acute COVID-19 outbreak in April 2020. Acta Clin Belg. 2022;77(2):295- 300.
• Aziz H, Fatima S, Mahmood H, Muhammad S, Saeed MA, Khurshid S, Aslam W, Aziz S, Faheem M. Antibody Response to SARS CoV-2 in Relation to the Contributing Factors in COVID-19 Patients. Viral Immunol. 2022;35(2):142-149.
• Kanji JN, Zelyas N, MacDonald C, Pabbaraju K, Khan MN, Prasad A, Hu J, Diggle M, Berenger BM, Tipples G. False negative rate of COVID-19 PCR testing: a discordant testing analysis. Virol J. 2021; 9;18(1):13.
• Arevalo-Rodriguez I, Buitrago-Garcia D, Simancas-Racines D, Zambrano-Achig P, Del Campo R, Ciapponi A, et al. False negative results of initial RT-PCR assays for COVID-19: A systematic review. PLoS One. 2020 ;10;15(12):e0242958.
• Wu J, Liu X, Zhou D, Qiu G, Dai M, Yang Q, Pan Z, Zhou N, Wu P. Identification of RT-PCR Negative Asymptomatic COVID-19 Patients via Serological Testing. Front Public Health. 2020; 5;8:267.
• Chaimayo C, Kaewnaphan B, Tanlieng N, Athipanyasilp N, Sirijatuphat R, Chayakulkeeree M, Angkasekwinai N, Sutthent R et al. Rapid SARS-CoV-2 antigen detection assay in comparison with real-time RT-PCR assay for laboratory diagnosis of COVID-19 in Thailand. Virol J. 2020;13;17(1):177.
• Haghi Ashtiani MT, Sadeghi Rad P, Asnaashari K, Shahhosseini A, Berenji F, Mamishi S. Role of serology tests in COVID-19 non hospitalized patients: A cross-sectional study. PLoS One. 2022; 14;17(4):e0266923.