COVID-19’lu Çocuklarda PCR Yokluğunda Tanıda Bazı Laboratuvar Parametrelerinin Rolü

Abstract

Amaç: Enfeksiyon hastalıkları vücutta inflamasyon oluşturarak periferik kan hücrelerinde sayısal ve fonksiyonel değişikliklere neden olur. Coronavirüs hastalığı-19 (COVID-19), Polimeraz Zincir Reaksiyonu (PCR) testinin ile teşhis edilen bulaşıcı bir hastalıktır. Ancak PCR testi her zaman temin edilemeyebilir. Bu çalışmanın amacı, çocklarda kan parametrelerindeki sayısal ve fonksiyonel değişikliklerin PCR olmadığı durumda COVID-19 hızlı teşhisine etkisini değerlendirmektir. Metod: Çalışmaya 296 COVID-19 hasta ve 286 sağlıklı çocuk dahil edildi. Bilimsel araştırma için gereken izinler alındı. Değişkenlerin normal dağılımına uygunluğuna göre aanalizlerde bağımsız-t veya Mann-Whitney-U testleri uygulandı. Receiver Operating Characteristic (ROC) eğrileri ve lojistik regresyon modellemesi değerlendirildi. Bulgular: Grupların cinsiyeti ve yaşı benzerdir (p>0.05). Beyaz küre (WBC) (p<0.001), nötrofil (p<0.001), trombosit (p<0.001), lenfosit (p<0.001), ortalama trombosit hacmi (MPV) (p=0.009), laktat dehidrojenaz (LDH) (p=0.003), C-reaktif protein (CRP) (p<0.001) ve aspartat aminotransferaz (AST) (p=0.002) açısından iki grup arasında istatistiksel olarak anlamlı farklılıklar bulunmaktadır. ROC eğrisine bakıldığında, hastalarda LDH (p<0.001) ve CRP (p<0.001) daha yüksekken MPV (p=0.03), platelet (p=0.04), ve nötrofil (p<0.001) sonuçları daha düşüktür. Lojistik regresyonda en iyi model hemoglobin, nötrofil, lenfosit, trombosit, LDH ve CRP'yi içeren modeldi. Sonuç: COVID-19'un PCR yokluğunda hızlı teşhisi halk sağlığı için çok önemlidir. Kesin tanı için gerekli olan Gerçek Zamanlı Polimeraz Zincir Reaksiyonu (RT-PCR) her zaman sağlanamayabilir, bu nedenle daha kolay ve daha ucuz yöntemlere ihtiyaç vardır. Sınırlı sayıda katılımcıya rağmen bu çalışma çocuklarda labaratuvar parametreleri ile Covid-19'da hızlı tanıyı desteklemektedir.

Keywords

• COVİD-19
• çocuk
• laboratuvar parametreleri

The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19

Abstract

Objective: Infectious diseases cause inflammation in the human body and produce numerical and functional changes in peripheral blood cells. Coronavirus disease-19 (COVID-19) is also an infectious disease diagnosed by the Polymerase Chain Reaction (PCR) test. However, PCR testing may not always be available. The aim of this study is to show the effect of numerical and functional changes in blood parameters on the diagnosis of COVID-19 in children. Method: In this retrospective study, 296 patients and 286 healthy children were included. Nasopharyngeal swabs were collected. The swabs were analyzed by Real-time PCR. Independent-t/Mann-Whitney-U tests were applied; Receiver Operating Characteristic (ROC) curves and logistic regression modelling were evaluated. Result: Gender and age distributions of the groups were similar (p>0.05). There were significant differences between the two groups in terms of white blood cell (WBC) (p<0.001), neutrophil (p<0.001), thrombocyte (p<0.001), lymphocyte (p<0.001), mean platelet volume (MPV) (p=0.009), lactate dehydrogenase (LDH) (p=0.003), C-reactive protein (CRP) (p<0.001) and aspartate aminotransferase (AST) (p=0.002). It was found in ROC curve analyses, while LDH (p<0.001) and CRP (p<0.001) values were higher in patients, MPV (p=0.03), platelet (p=0.04), and neutrophil (p<0.001) values of them were lower. The best model in logistic regression was the model that included hemoglobin, neutrophil, lymphocyte, thrombocyte, LDH and CRP. Conclusion: Rapid diagnosis of COVID-19 are crucial for public health. PCR, required for definitive diagnosis, may not always be achieved, so easier and cheaper methods are needed. This study supports the diagnosis of COVID-19 in the children in the absence of PCR.

Keywords

• COVID-19
• child
• laboratory parameters
• diagnosis

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