Üçüncü Basamak Sağlık Kuruluşuna Başvuran Hastalarda COVID-19 Serolojisinin İncelenmesi

Yıl 2023, Cilt: 7 Sayı: 1, 83 - 88, 16.04.2023

Pelin Onarer , Tuğçe Ünalan-altıntop , Fikriye Milletli Sezgin

https://doi.org/10.46332/aemj.1061193

Öz

Amaç: Hastanemize başvuran hastalarda PCR testi sonrası SARS-CoV-2 spesifik antikor bakılan hastalar retrospektif olarak taranıp, ilimizin serolojik profili hakkında fikir edinmek amaçlanmıştır.

Araçlar ve Yöntem: Laboratuvarımıza Ocak-Haziran 2021 tarihleri arasında, serum örneklerinde anti SARS-CoV-2 IgG ve/veya IgM çalışılan hastalar retrospektif olarak incelenip dahil edildi. Eş zamanlı olarak SARS-CoV-2 PCR testi uygulandı.

Bulgular: 725 hastanın 123’üne IgM veya IgG olmak üzere yalnızca bir istem yapılmış, 602 kişiye ise IgM ve IgG birlikte istenmişti. PCR testi ile anti SARS-CoV-2 IgG ve/veya IgM istemleri arasında 30 gün süre bulunan hastalara bakıldığında ise toplam 304 (%42) hastanın 40 (%13)’ının PCR testi pozitif olarak saptanmıştır, bu hastaların 60%’ının 30 gün içindeki IgM ve IgG iki testi birlikte pozitif olarak bulunmuştur. PCR testi negatif 264 hastadan %64’ünün IgM ve IgG testi negatif bulunmuştur. Sonuçlarımıza göre, testlerin %58’i PCR istemi olmadan istenmiştir. PCR ve seroloji istemleri arasındaki süreler incelendiğinde ilk 7 gün içerisinde 233 (%76.6) seroloji istemi, 8-14 gün içinde 27 (%8.8), 15-21 gün içinde 7 (%2.3), 22-30 gün içinde 37 (%12.3) istem yapıldığı görülmüştür. 117 (%38.5) istemde PCR ve serolojinin aynı anda yapıldığı saptanmıştır.

Sonuç: DSÖ serolojik test istemlerinin PCR testinden sonraki 1. ve 3-4. haftalarda yapılmasını önermektedir. Hastanemizde yüksek oranda uygun olmayan istem yapıldığı görülmekte olup bu durum serolojik test istem algoritma eksikliğini göstermektedir. Serolojik testlerin COVID19 hastalığının tanısında tek başına kullanımı değil; nükleik asit testleriyle birlikte ve onlara yardımcı olarak kullanımı önerilmektedir. Bu durum bize aşı sonrası antikor yanıtını görmek için gereksiz test istemine yol açıldığını düşündürmüştür.

Anahtar Kelimeler

COVID19, PCR, IgG, IgM, CLIA

Investigation of COVID-19 Serology in a Tertiary Care Center

Öz

Purpose: This study aimed to screen the patients admitted to our hospital for SARS-CoV-2 specific antibodies after a PCR test and understand the local serological profile.

Materials and Methods: The patients tested for anti-SARS-CoV-2 IgG and/or IgM between January-June 2021 were included in the study. SARS-CoV-2 PCR test was performed simultaneously.

Results: Either IgM or IgG alone was requested in 123 of 725 patients, and IgM and IgG together in 602. The PCR test was positive in 40 (13%) of 304 (42%) patients who had a PCR test after 30 days of the serology request. Of these PCR-positive patients, 60% had IgM and IgG antibodies together, whereas among 204 PCR-negative patients, 64% tested negative for IgM and IgG. 58% of the tests were ordered without a PCR request. The period between PCR and serology testing was as follows: 233 (76.6%) in 7 days, 27 (8.8%) in 8-14 days, 7 (2.3%) in 15-21 days, and 37 (12.3%) in 22-30 days. 117 (38.5%) of the requests were made simultaneously.

Conclusion: WHO recommends that serology testing should be performed after the 1st and 3-4th week of the initial PCR test. The high rate of inappropriate testing demonstrates a lack of algorithms. The use of serological tests is recommended in conjunction with nucleic acid tests but not to be used alone in the diagnosis of COVID-19. Our results demonstrated the high rate of unnecessary requests for serology testing to determine the antibody response against SARS-CoV-2 vaccines.

Anahtar Kelimeler

COVID19, PCR, IgG, IgM, CLIA

Kaynakça

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