Özgen Alpaydın Aylin, Appak Özgür, Gezer Naciye Sinem, Yiğit Salih, Gündüz Karayazı Damla, Kuruüzüm Ziya, Ömeroğlu Şimşek Gökçen, Eren Kutsoylu Oya Özlem, Sayıner Ayça Arzu, Sevinç Can, Uçan Eyüp Sabri, Uğur Yasin Levent, Gökmen Ali Necati, Yapar Nur
Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Department of Medical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Thorac Res Pract. 2023 Mar;24(2):91-95. doi: 10.5152/ThoracResPract.2023.22187.
There have been doubts that SARS-CoV-2 has been circulating before the first case was announced. The aim of this study was to evaluate the possibility of COVID-19 in some cases diagnosed to be viral respiratory tract infection in the pre-pandemic period in our center.
Patients who were admitted to our hospital's pulmonary diseases, infectious diseases, and intensive care clinics with the diagnosis of viral respiratory system infection within a 6-month period between October 2019 and March 12, 2020, were screened. Around 248 archived respiratory samples from these patients were analyzed for SARS-CoV-2 ribonucleic acid by real-timequantitative polymerase chain reaction. The clinical, laboratory, and radiological data of the patients were evaluated.
The mean age of the study group was 47.5 (18-89 years); 103 (41.5%) were female and 145 (58.4%) were male. The most common presenting symptoms were cough in 51.6% (n = 128), fever in 42.7% (n = 106), and sputum in 27.0% (n = 67). Sixty-nine percent (n = 172) of the patients were pre-diagnosed to have upper respiratory tract infection and 22.0% (n = 55) had pneumonia, one-third of the patients (n = 84, 33.8%) were followed in the service. Respiratory viruses other than SARS-CoV-2 were detected in 123 (49.6%) patients. Influenza virus (31.9%), rhinovirus (10.5%), and human metapneumovirus (6.5%) were the most common pathogens, while none of the samples were positive for SARS-CoV-2 RNA. Findings that could be significant for COVID-19 pneumonia were detected in the thorax computed tomography of 7 cases.
The negative SARS-CoV-2 real-time-quantitative polymerase chain reaction results in the respiratory samples of the cases followed up in our hospital for viral pneumonia during the pre-pandemic period support that there was no COVID-19 among our cases during the period in question. However, if clinical suspicion arises, both SARS and non-SARS respiratory viral pathogens should be considered for differential diagnosis.
有人怀疑严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在首例病例公布之前就已传播。本研究的目的是评估在我们中心大流行前时期被诊断为病毒性呼吸道感染的某些病例中感染新型冠状病毒肺炎（COVID-19）的可能性。
对2019年10月至2020年3月12日这6个月期间因病毒性呼吸系统感染诊断而入住我院肺病科、传染病科和重症监护科的患者进行筛查。通过实时定量聚合酶链反应对这些患者的约248份存档呼吸道样本进行SARS-CoV-2核糖核酸分析。对患者的临床、实验室和放射学数据进行评估。
研究组的平均年龄为47.5岁（18 - 89岁）；女性103例（41.5%），男性145例（58.4%）。最常见的症状为咳嗽，占51.6%（n = 128），发热占42.7%（n = 106），咳痰占27.0%（n = 67）。69%（n = 172）的患者预先诊断为上呼吸道感染，22.0%（n = 55）患有肺炎，三分之一的患者（n = 84，33.8%）在该科室接受随访。123例（49.6%）患者检测到除SARS-CoV-2之外的呼吸道病毒。流感病毒（31.9%）、鼻病毒（10.5%）和人偏肺病毒（6.5%）是最常见的病原体，而所有样本的SARS-CoV-2 RNA均为阴性。7例患者的胸部计算机断层扫描发现了可能对COVID-19肺炎有意义的表现。
在我院大流行前时期对病毒性肺炎进行随访的病例的呼吸道样本中，SARS-CoV-2实时定量聚合酶链反应结果为阴性，这支持在所研究的时期内我们的病例中没有COVID-19。然而，如果出现临床怀疑，则应考虑SARS和非SARS呼吸道病毒病原体进行鉴别诊断。
