İKİ SAĞLIK ÇALIŞANINDA OLASI COVID-19 REENFEKSİYONU: LİTERATÜRÜN GÖZDEN GEÇİRİLMESİ İLE TÜRKİYE'DEN İLK VAKA RAPORU

COVID-19 pandemisinin en yoğun günlerini yaşadığımız bu günlerde hastalığı geçirenlerde bir süre sonrabenzer klinik tablolar gözlenmiş olması ve birkaçı sağlık çalışanlarında olmak üzere olası re-enfeksiyonvakalarının rapor edilmesi COVID-19'a karşı kazanılan doğal bağışıklık ile ilgili ciddi endişelere yol açmıştır.Biz burada Türkiye'de ilk kez sağlık çalışanlarında iki olası re-enfeksiyon vakasını rapor ediyoruz. İlk vakaCOVID-19 vakalarının izlendiği bir yoğun bakım servisinde çalışan 21 yaşındaki erkek hemşiredir. Halsizlik,şiddetli kas ağrısı ve boğaz ağrısı şikayetleri sonrası 10 Ağustos'ta RT-PCR testi pozitif olarak bildirilmiştir.Toraks BT normal olarak değerlendirilmiştir. İlgili protokole göre tedavi alan ve izlenen hasta 25-26 Ağustostarihlerinde art arda alınan iki RT-PCR testinin negatif olması üzerine işine geri dönmüştür. Bundan 76 günsonra halsizlik, şiddetli kas ağrısı, boğaz ağrısı ve ishal şikayetleri ile yeniden başvuran hastanın RT-PCR pozitifolarak rapor edilmiştir. İkinci vaka COVID-19 hastalarının izlendiği bir serviste çalışan 28 yaşındaki kadındoktordur. Sub-febril ateşin eşlik ettiği yorgunluk, şiddetli kas ağrısı, baş ağrısı, öksürük, anozmi ve disguzişikayetleri sonrası 25 Ağustos'ta gerçekleştirilen RT-PCR testi pozitif olarak rapor edilmiştir. İlgili protokolegöre tedavi verilen ve izlenen hasta şikâyetlerinin geçmesi ve 10 ve 15 Eylül'deki RT-PCR testlerinin negatifraporlanması üzerine işine dönmüştür. Bundan 71 gün sonra yorgunluk, kas ağrısı, boğaz ağrısı, baş ağrısı, sub febril ateş ve ara sıra kuru öksürük şikayetleri sonrası alınan RT-PCR testi pozitif olarak değerlendirilmiştir.Toraks BT incelemesi normal olarak raporlanmıştır. Vakalar, bu konuda literatürde yer alan benzer yayınlar veher iki klinik durumda izole edilen suşların genom dizilimlerinin incelendiği çalışmaların sonuçları ile ayrıntılıolarak tartışılmıştır.

POSSIBLE COVID-19 REINFECTION IN TWOHEALTHCARE WORKERS: A FIRST CASE REPORT FROMTURKEY WITH REVIEW OF THE LITERATURE

In these worse days of the COVID-19 pandemic, it was reported that similar clinical pictures were observed after a while in those who suffered from the disease suggesting possible cases of reinfection. Some of these cases were among healthcare workers. These reports have raised serious concerns about the natural immunity gained against COVID-19. We report here two possible cases of reinfection in healthcare workers for the first time in Turkey. The first case was a 21-year-old male nurse working in a COVID-19 intensive care unit. RT-PCR test was reported positive on August 10 after complaints of weakness, severe muscle pain, and sore throat. The patient, who received treatment and was followed up according to the protocol, returned to work when two consecutive RT-PCR tests were negative on August 25-26. After 76 days, the patient who presented with complaints of weakness, severe muscle pain, sore throat, and diarrhea had again a positive RT-PCR. The second case was a 28-year-old female doctor working in a COVID-19 clinic. Her RT-PCR test was performed on 25 August after complaints of fatigue, severe muscle pain, headache, cough, anosmia, and dysgeusia accompanied by sub febrile fever were reported positive. She returned to work after two RT-PCR tests on September 10 and 15 were reported negative. Seventy-one days later, the RT-PCR test taken after complaints of fatigue, muscle pain, sore throat, headache, sub febrile fever, and occasional dry cough was evaluated as positive. The cases were discussed in detail with the review of the literature.

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