Evaluation of Antibody Levels in Patients Radiologically Considered to Have Covid-19 Pneumonia

Yıl 2023, Cilt: 12 Sayı: 2, 105 - 113, 31.08.2023

Gözde Öksüzler Kızılbay , Serap Argun Barış , Emel Azak Karali , Aynur Karadenizli , Hüseyin Uzuner , Sevtap Doğan , Haşim Boyacı , İlknur Başyiğit

https://doi.org/10.47493/abantmedj.1246500

Öz

AIM
The aim of this study is to evaluate the results of the COVID-19 antibody test in patients with negative COVID-19 RTPCR tests but accepted as COVID-19 pneumonia due to typical radiological findings.
MATERIAL and METHODS
SARS-CoV2 Total (IgM + IgG) and IgG antibody levels were studied by ELISA method of 28 patients with typical findings in terms of COVID-19 pneumonia. 10 of them had positive PCR examination (definite COVID-19 pneumonia), 18 had negative PCR examination (possible COVID-19 pneumonia). As the control group, 10 patients before the first COVID19 patient was detected in our country whose radiological findings were evaluated as compatible with COVID-19 pneumonia were included.
RESULTS
While no COVID-19 antibody was detected in any of the patients included in the control group. Antibody was negative in only 1 of the patients with definite COVID-19 pneumonia. It was determined that this patient was still receiving chemotherapy with the diagnosis of diffuse Non-Hodgkin Lymphoma. In the probable COVID-19 pneumonia group, no antibodies were detected in 5 patients (27.7%). Two of these patients were diagnosed with multiple myeloma, and three patients were over 75 years of age. There was no significant difference between the definite and probable COVID-19 groups in terms of mean total and IgG antibody levels (Ig G levels 2.57 ± 1.08 vs 2.84 ± 0.9, p=0.6).
CONCLUSİON
COVID-19 antibody levels can be used for the diagnosis of COVID-19 infection in patients with radiologically suspected COVID-19 pneumonia. However, it should be kept in mind that adequate antibody response may not occur in elderly and immunosuppressed patients, it may be difficult to show a previous infection.

Anahtar Kelimeler

COVID-19, antibody, diagnosis

Radyolojik Olarak Covid-19 Pnömonisi Düşünülen Hastalarda Antikor Düzeylerinin Değerlendirilmesi

Öz

AMAÇ
Bu çalışmanın amacı, üst solunum yolu örneklerinde COVID-19 RT-PCR tetkiki negatif bulunan fakat tipik radyolojik bulguları nedeniyle COVID-19 pnömonisi olarak kabul edilen hastalarda COVID-19 antikor tetkiki sonuçlarının değerlendirilmesidir.
GEREÇ VE YÖNTEMLER
Hastanemizde yatırılan COVID-19 pnömonisi açısından tipik bulguları olan 28 hastadan periferik kanda ELISA yöntemi ile SARS-CoV2 Total (IgM + IgG) ve IgG antikor düzeylerinin çalışıldı. 10 hastanın yatış sırasında PCR tetkiki pozitif (kesin COVID-19 pnömonisi), 18 hastanın ise PCR tetkiki negatif (olası COVID-19 pnömonisi) olduğu görüldü. Kontrol grubu olarak Kasım 2019-Mart 2020 tarihleri arasında, ülkemizde ilk COVID-19 hastası tespit edilmeden önce yatırılan ve radyolojik bulguları COVID-19 pnömonisi ile uyumlu olarak değerlendirilen 10 hasta alındı (kontrol).
BULGULAR
Kontrol grubu olarak alınan hastaların hiç birinde COVID-19 antikoru tespit edilmezken, radyolojik olarak COVID-19 pnömonisi tanısı alan 28 hastanın 22 tanesinde (%78.6) antikor pozitif bulundu. Kesin COVID-19 pnömonisi olan hastaların sadece 1 tanesinde antikor negatif bulundu. Bu hastanın yaygın Non-Hodgkin Lenfoma tanısı ile halen kemoterapi almakta olduğu tespit edildi. Olası COVID-19 pnömonisi grubunda 5 hastada antikor tespit edilmedi (%27.7). Bu hastaların ikisinin multipl miyelom tanılı olduğu, üç hastanın ise 75 yaş üzeri olduğu dikkati çekti. Kesin ve olası COVID-19 grupları arasında ortalama total ve IgG antikor düzeyleri açısından anlamlı fark tespit edilmedi (IgG düzeyleri 2.57 ± 1.08 vs 2.84 ± 0.9, p=0.6).
SONUÇ
Pandemi döneminde radyolojik olarak COVID-19 pnömonisi düşünülen hastalarda geçirilmiş COVID enfeksiyonu tanısı için COVID-19 antikor düzeyleri kullanılabilir. Fakat, yaşlı ve hematolojik malignite başta olmak üzere immunsupresyonu olan hastalarda yeterli antikor yanıtı oluşmayabileceği, bu nedenle geçirilmiş enfeksiyonu göstermenin güç olabileceği akılda tutulmalıdır.

Anahtar Kelimeler

COVID-19, antikor, tanı

Kaynakça

• Zhao J, Yuan Q, Wang H, Liu W, Liao X, Su Y, vd. Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. Clin Infect Dis. 19 Kasım 2020;71(16):2027-34.
• WHO Coronavirus (COVID-19) Dashboard [Internet]. [a.yer 22 Kasım 2022]. Erişim adresi: https://covid19.who.int
• El Homsi M, Chung M, Bernheim A, Jacobi A, King MJ, Lewis S, vd. Review of chest CT manifestations of COVID-19 infection. Eur J Radiol Open. 2020;7:100239.
• Zhu W, Xie K, Lu H, Xu L, Zhou S, Fang S. Initial clinical features of suspected coronavirus disease 2019 in two emergency departments outside of Hubei, China. J Med Virol. Eylül 2020;92(9):1525-32.
• Guan W jie, Ni Z yi, Hu Y, Liang W hua, Ou C quan, He J xing, vd. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 30 Nisan 2020;382(18):1708-20.
• Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney SP, Shehata AA. The COVID-19 Pandemic: A Comprehensive Review of Taxonomy, Genetics, Epidemiology, Diagnosis, Treatment, and Control. J Clin Med. 24 Nisan 2020;9(4):1225.
• Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, vd. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. :23.
• Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, vd. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology. Nisan 2020;295(1):202-7.
• Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, vd. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol. Haziran 2020;30(6):3306-9.
• Kim H. Outbreak of novel coronavirus (COVID-19): What is the role of radiologists? Eur Radiol. Haziran 2020;30(6):3266-7.
• Munster VJ, Koopmans M, van Doremalen N, van Riel D, de Wit E. A Novel Coronavirus Emerging in China — Key Questions for Impact Assessment. N Engl J Med. 20 Şubat 2020;382(8):692-4.
• Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, vd. Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. J Med Virol. Eylül 2020;92(9):1518-24.
• Imai K, Tabata S, Ikeda M, Noguchi S, Kitagawa Y, Matuoka M, vd. Clinical evaluation of an immunochromatographic IgM/IgG antibody assay and chest computed tomography for the diagnosis of COVID-19. J Clin Virol. Temmuz 2020;128:104393.
• Rubin GD, Ryerson CJ, Haramati LB, Sverzellati N, Kanne JP, Raoof S, vd. The Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statement from the Fleischner Society. Radiology. Temmuz 2020;296(1):172-80.
• Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, vd. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 19 Mart 2020;382(12):1177-9.
• Wang M, Wu Q, Xu W, Qiao B, Wang J, Zheng H, vd. Clinical diagnosis of 8274 samples with 2019-novel coronavirus in Wuhan [Internet]. Infectious Diseases (except HIV/AIDS); 2020 Şub [a.yer 29 Kasım 2022]. Erişim adresi: http://medrxiv.org/lookup/doi/10.1101/2020.02.12.20022327
• Patel R, Babady E, Theel ES, Storch GA, Pinsky BA, St. George K, vd. 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. 28 Nisan 2020;11(2):e00722-20.
• Li G, Chen X, Xu A. Profile of Specific Antibodies to the SARS-Associated Coronavirus. N Engl J Med. 31 Temmuz 2003;349(5):508-9.
• Chen M, Qin R, Jiang M, Yang Z, Wen W, Li J. Clinical applications of detecting IgG, IgM or IgA antibody for the diagnosis of COVID-19: A meta-analysis and systematic review. Int J Infect Dis. Mart 2021;104:415-22.
• Zhong L, Chuan J, Gong B, Shuai P, Zhou Y, Zhang Y, vd. Detection of serum IgM and IgG for COVID-19 diagnosis. Sci China Life Sci. Mayıs 2020;63(5):777-80.
• Long QX, Liu BZ, Deng HJ, Wu GC, Deng K, Chen YK, vd. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. Haziran 2020;26(6):845-8.
• Okba NMA, Müller MA, Li W, Wang C, GeurtsvanKessel CH, Corman VM, vd. Severe Acute Respiratory Syndrome Coronavirus 2−Specific Antibody Responses in Coronavirus Disease Patients. Emerg Infect Dis. Temmuz 2020;26(7):1478-88.