Gül BAYRAM, Harun GÜLBUDAK, Taylan BOZOK, Mehtap AKÇA, Ali Türker ÇİFTÇİ, Necdet KUYUCU, Gönül ASLAN

SARS-CoV-2 enfeksiyonu pozitif çocuk hastaların gerçek zamanlı PCR döngü eşik değeri, epidemiyolojik ve klinik özelliklerinin retrospektif olarak değerlendirilmesi

Amaç: COVID-19’un yol açtığı şiddetli klinik sonuçlara neden olan risk faktörleri yetişkin hastalarda çocuk hasta grubuna göre daha iyi tanımlanmıştır. Bu çalışmada hastanemize COVID-19 şüphesi ile başvuran ve SARS-CoV-2 testi pozitif saptanan çocuk hastalarda sosyo-demogrofik özellikler, klinik bulgular ve eşik değeri “cycle threshold” (Ct) değeri arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Yöntem: Çalışmada 1 Mayıs 2020-31 Ekim 2021 tarihleri arasında Mersin Üniversitesi Hastanesi COVID-19 laboratuvarında SARS-CoV-2 RT-qPCR testi pozitif saptanan 2971 çocuk hasta çalışmaya dahil edilmiştir. SARS-CoV-2 RT-qPCR testi, nazofarengeal ve orofarengeal sürüntü örneklerinden yapılmıştır. RT-qPCR sonucundan elde edilen Ct değerleri düşük, orta, yüksek şeklinde sınıflandırılmıştır. Bulgular: SARS-CoV-2 enfeksiyonu pozitif olan çocuk hastalarda en sık görülen semptomlar sırasıyla ateş %41.5, öksürük %28.6 ve boğaz ağrısı %24.4 olarak belirlenmiştir. SARS-CoV-2 pozitif asemptomatik ve semptomatik çocuk hastaların Ct değerleri düşüktür (<24) ve hastalar yüksek risk grubunda yer almaktadır. SARS-CoV-2 pozitif çocuklarda semptomlar ve Ct grupları arasındaki ilişki değerlendirildiğinde özellikle ateş (%43.1), halsizlik (%18.8) ve baş ağrısı (%16.3) semptomu gösteren hastaların yüksek viral yük grubunda olduğu saptanmıştır. Sonuç: Çalışmamızda yer alan temaslı hastaların çoğunun COVID-19’lu aile üyelerinden birine maruz kalması nedeniyle Ct değerinin düşük olduğu düşünülmektedir. Bundan dolayı potansiyel bulaştırıcılıkları yüksek olan bu temaslı grubunun takibi, kontrolü ve izolasyonu halk sağlığı açısından önemli bir noktadır.

Anahtar Kelimeler:

SARS-CoV-2, COVID-19, eşik değeri (Ct), semptom

Retrospective evaluation of epidemiological, clinical and Real-time PCR cycle threshold of SARS-CoV-2 infection positive pediatric patients

Aim: Risk factors that cause severe clinical outcomes caused by COVID-19 are better defined in adult patients than in the pediatric patient group. In this study, it was aimed to evaluate the relationship between socio-demographic characteristics, clinical findings and cycle threshold (Ct) value in pediatric patients who applied to our hospital with the suspicion of COVID-19 and were found to have a positive SARS-CoV-2 test. Method: In the study, 2971 pediatric patients with positive SARS-CoV-2 RT-qPCR test in Mersin University Hospital COVID-19 laboratory between 1 May 2020 and 31 October 2021 were included in the study. The SARS-CoV-2 RT-qPCR test was performed on nasopharyngeal and oropharyngeal swab samples. Ct values obtained from the RT-qPCR result were classified as low, moderate, and high. Results: The most common symptoms in pediatric patients with positive SARS-CoV-2 infection were fever 41.5%, cough 28.6% and sore throat 24.4%, respectively. Ct values of SARS-CoV-2 positive asymptomatic and symptomatic pediatric patients are low (<24) and the patients are in the high risk group. When the relationship between symptoms and Ct groups in SARS-CoV-2 positive children was evaluated, it was determined that patients with fever (43.1%), fatigue (18.8%) and headache (16.3%) were in the high viral load group. Conclusion: Most of the contact patients in our study were thought to have low Ct value because they were exposed to a family member with COVID-19. Therefore, monitoring, control and isolation of this contact group with high potential contagion is an important point in terms of public health.

Keywords:

SARS-CoV-2, COVID-19, cycle threshold (Ct), symptom,

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