Bir Üniversite Acil Servisinde RT-PCR Testi ile Teyit Edilmiş COVID-19 Vakalarını Öngörmede Kullanılabilecek Faktörler

Abstract

ABSTRACT Arslan V., Factors That Can Be Used to Predict Covid-19 Cases Confirmed by RT-PCR Test in a University Emergency Department; Hacettepe University Health Science Institude, Epidemology Thesis, Ankara 2025 The COVID-19 (SARS-CoV-2) pandemic, which started in Wuhan, China at the end of 2019 and spread all over the world, is still ongoing, although its impact seems to have decreased in terms of hospitalizations and deaths. Due to the different variants that have emerged in more than two years, no specific symptom or finding has been identified for the diagnosis of COVID-19; the fact that the symptoms of the disease can also be seen in other diseases is another factor that makes diagnosis difficult. No test other than COVID-19 PCR gives disease-specific results; on the other hand, false-negative tests may also occur depending on the severity of the disease, time of test collection, type of test used, vaccination status of the patient, etc. COVID-19 infection can be seen in clinical practice as it can have a significantly asymptomatic course, and COVID-19 PCR positivity can be detected in tests performed even if the reason for the patient's presentation to healthcare services is different (e.g. traffic accident). In order to minimize the transmission in the community, RT-PCR testing for COVID-19 should be performed for all patients admitted to clinics during the pandemic period, regardless of the reason for admission, in all hospital admissions and/or before invasive procedures, confirming our clinical observation. With the decrease in the impact of the pandemic, the number of patients undergoing COVID PCR testing has decreased considerably. On 26.04.2022, based on the meeting held by the Scientific Advisory Board on 26.04.2022, according to the circular published by the General Directorate of Public Health on 05.05.2022, the obligation to perform COVID PCR test during hospitalizations or before invasive procedures (surgery, endoscopy, etc.) was abolished (3). Today, the suspicion of COVID must be aroused in the physician evaluating the patient in order to perform a COVID PCR test. In addition to the highly probable asymptomatic course of the disease, it is possible that COVID diagnoses are missed in some patients in emergency departments due to the current high patient density and rapid circulation. It can be predicted that the false negative diagnosis of patients after the abolition of the test requirement may increase the risk of nosocomial transmission/infection by increasing the possibility of COVID-19 transmission to healthcare personnel serving the patient and/or patients followed up in hospitals. With a retrospective study, based on the records of patients who applied to the Emergency Department of the Adult Hospital of our University during the pandemic and test obligation period and for whom a PCR test was requested, it is aimed to determine whether the diseases whose PCR test result is positive and whose COVID-19 diagnosis is confirmed can be predicted by personal characteristics, anamnesis, physical examination, laboratory and imaging findings, and if so, which symptoms and findings will be guiding. In this way, it is aimed to provide physicians who are likely to encounter COVID-19 patients in the coming period with a list of factors that they should question and/or check, and accordingly, to catch and isolate possible COVID-19 patients in the early period, even if the reason for admission is unrelated (e.g. traffic accident), thus preventing transmission and protecting healthcare personnel and other patients and their relatives from SARS-CoV-2 virus transmission. Key Words: COVID-19, emergency medicine, RT-PCR