PCR-testiranje na SARS-CoV-2 u Domu zdravlja Zagreb-Centar u 2020. godini: pregled kriterija upućivanja i dobivenih rezultata

Ana Mašić, Maja Matleković, Mirna Čilić, Ana Vukić, Ana Marija Jurić, Antonia Sirovatka, Ino Kermc, Antonija Balenović

Cilj: Analizirati rezultate PCR testiranja na SARS-CoV-2 učinjenih u tijeku pandemije COVID-19 u Hrvatskoj, od 9. travnja 2020. u Domu zdravlja Zagreb – Centar, koristeći heteroanamnestičke podatke o epidemiološkoj anamnezi i kliničkoj slici zbog kojih je postavljena sumnja na COVID-19 infekciju, a koji su dobiveni od obiteljskih liječnika i pacijenata. Materijali i metode: Podatci o epidemiološkoj anamnezi i simptomima vezanim uz moguće COVID-19 oboljenje traženi su prilikom naručivanja na testiranje. Navedeni podatci razdvojeni su na pojedinačne tvrdnje koje su se označavale s “DA” ako su bile istinite za pacijenta. Dobivene informacije obrađene su metodama deskriptivne statistike. Rezultati: Najčešći simptom navođen kao razlog za naručivanje bila je povišena temperatura, definirana tjelesnom temperaturom iznad 37,2°C (prijavljena u 78,79% slučajeva, u 84,08% pozitivnih i u 74,97% negativnih). Drugi najčešći simptom bio je kašalj (32,88%, 32,41%, odnosno 33,22%), zatim opći simptomi poput malaksalosti i slabosti (22,81%, 21,82%, odnosno 23,53%) te glavobolja. Više od 60% slučajeva anosmije i/ili disgeuzije registrirano je uz pozitivan nalaz na SARS-CoV-2. Gastrointestinalne simptome imalo je manje od 5% pozitivnih pacijenata, a kataralne simptome, od kojih su izdvojeni kašalj i grlobolja kao zasebno evidentirani, imalo je manje od 10% pozitivnih pacijenata. Zaključci: Razlozi za upućivanje na testiranje mijenjali su se ovisno o smjernicama Hrvatskog zavoda za javno zdravstvo, o novim medicinskim saznanjima te širenju informacija putem medija. Uz poštivanje smjernica, obiteljski liječnik uvijek je u kliničkom prosuđivanju koristio principe osobi orijentirane skrbi.

Goal: Analyze the results of PCR tests for SARS-CoV-2 performed during the pandemic of COVID-19 in Croatia, from April 9, 2020, at the Health Center Zagreb-Center, based on heteroanamnestic data of the epidemiological history and symptoms due to which the suspicion of COVID-19 infection was made, and which were given by family physicians or patients. Materials and methods: Data on epidemiological history and symptoms related to possible COVID-19 disease were requested when ordering patients for testing. The presented data were divided into individual claims, and marked with “YES” if they were true for the patient. The obtained information
was processed by methods of descriptive statistics. Results: The most common symptom mentioned in ordering SARS-CoV-2 PCR test was fever, defined by a body temperature above 37.2° C (reported in the total of 78.79% cases, in 84.08% of positive, and in 74.97% of negative). The second most common symptom was cough (32.88%, 32.41%, 33.22%, respectively), followed by general symptoms such as malaise and weakness (22.81%, 21.82%, 23.53%, respectively), and headache. In more than 60% of cases anosmia, a loss of the sense
of taste and smell, was registered with a positive SARS-CoV-2 finding. Less than 5% of positive patients had gastrointestinal symptoms, and catarrhal symptoms, of which cough and sore throat have been singled out, were registered in less than 10% of positive patients. Conclusions: The reasons for referral for PCR testing ranged depending on the guidelines of the Croatian Institute of Public Health, new medical knowledge, and the flow of information through the media. The family physician, in compliance with the guidelines, has always used the principles of person-centered care in clinical judgment.