Pelin ONARER, Tuğçe ÜNALAN-ALTINTOP, Fikriye MİLLETLİ SEZGİN

Üçüncü Basamak Sağlık Kuruluşuna Başvuran Hastalarda COVID-19 Serolojisinin İncelenmesi

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

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.

Keywords:

COVID19, PCR, IgG, IgM, CLIA,

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