Gözde ÖKSÜZLER KIZILBAY, Serap ARGUN BARIŞ, Emel AZAK KARALİ, Aynur KARADENİZLİ, Hüseyin UZUNER, Sevtap DOĞAN, Haşim BOYACI, İlknur BAŞYİĞİT

Radyolojik Olarak Covid-19 Pnömonisi Düşünülen Hastalarda Antikor Düzeylerinin Değerlendirilmesi

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

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

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.

Keywords:

COVID-19, antibody, diagnosis,

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