Covid-19: fatores pré-analíticos em RT-PCR de protocolo alternativo utilizado no município de Jaboticabal/SP
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Data
2022-11-21
Autores
Alonso, Giovana Rosa Luiz
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Os sintomas da covid-19 são inespecíficos, o que dificulta seu diagnóstico clínico. A técnica molecular (RT-PCR) é a escolha padrão-ouro para o diagnóstico laboratorial. Por meio do diagnóstico precoce da doença é possível monitorar o paciente, produzindo prognósticos mais favoráveis, além da importância epidemiológica de rastreamento dos casos positivos com indicação de isolamento de infectados e seus contactantes. Contudo, existem determinados fatores pré-analíticos que poderiam predizer os resultados de testes e que merecem atenção. Por esse motivo, o presente estudo analisou os fatores pré-analíticos da RT-PCR de protocolo alternativo. Os fatores analisados foram idade, sexo, raça, sintomas relatados, comorbidades, parâmetros clínicos, período da sintomatologia clínica e qualidade da colheita da amostra (gene GAPDH). Utilizando 400 prontuários de pacientes atendidos no Centro de Atendimento ao Coronavírus (CAC) no Município de Jaboticabal/SP, determinou-se quais apresentaram associação com os resultados dos exames, por meio da técnica de regressão logística simples e multivariável. As variáveis significativas foram “alteração de olfato e/ou paladar” e “tosse”, com P < 0,05. Portanto, são sintomas frequentemente presentes, sendo indicativos na triagem para solicitar exame diagnóstico e, em casos de distúrbio olfatório, isolamento precoce e prolongado do paciente.
The symptoms of covid-19 are nonspecific, which makes its clinical diagnosis difficult. The molecular technique (RT-PCR) is the gold standard choice for laboratory diagnosis. Through early diagnosis of the disease, it is possible to monitor the patient, producing more favorable prognoses, in addition to the epidemiological importance of tracking positive cases with indication of isolation of infected and their contacts. However, there are certain pre-analytical factors that could predict test results that deserve attention. For this reason, the present study analyzed the pre-analytical factors of alternative protocol RT-PCR. The factors analyzed were age, sex, race, reported symptoms, comorbidities, clinical parameters, period of clinical symptoms and quality of sample collection (GAPDH gene). Using 400 medical records of patients treated at the Coronavirus Care Center (CCC) in the city of Jaboticabal, state of São Paulo, it was determined which ones were associated with the test results, using the simple and multivariate logistic regression technique. The significant variables were “alteration of smell and/or taste” and “cough”, with P < 0.05. Therefore, these symptoms are frequently present, being indicative in screening to request a diagnostic test and, in cases of olfactory disorder, early and prolonged isolation of the patient.
The symptoms of covid-19 are nonspecific, which makes its clinical diagnosis difficult. The molecular technique (RT-PCR) is the gold standard choice for laboratory diagnosis. Through early diagnosis of the disease, it is possible to monitor the patient, producing more favorable prognoses, in addition to the epidemiological importance of tracking positive cases with indication of isolation of infected and their contacts. However, there are certain pre-analytical factors that could predict test results that deserve attention. For this reason, the present study analyzed the pre-analytical factors of alternative protocol RT-PCR. The factors analyzed were age, sex, race, reported symptoms, comorbidities, clinical parameters, period of clinical symptoms and quality of sample collection (GAPDH gene). Using 400 medical records of patients treated at the Coronavirus Care Center (CCC) in the city of Jaboticabal, state of São Paulo, it was determined which ones were associated with the test results, using the simple and multivariate logistic regression technique. The significant variables were “alteration of smell and/or taste” and “cough”, with P < 0.05. Therefore, these symptoms are frequently present, being indicative in screening to request a diagnostic test and, in cases of olfactory disorder, early and prolonged isolation of the patient.
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Palavras-chave
Pandemias, Covid-19, Diagnóstico, Vigilância epidemiológica, Saúde pública