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    Comparison of anti-spike IgG, anti-spike IgA levels and neutralizing antibody activity induced by CoronaVac and BNT162b2 vaccines in patients with inflammatory rheumatic diseases receiving immunosuppressive therapy
    (Springernature, 2023) Cosan, Fulya; Demirel, Ozlem Unay; Yalcin, Demet; Sonkaya, Muhammed Mert; Uluisik, Isilsu Ezgi; Cecen, Olida; Furuncuoglu, Yavuz
    BackgroundThe importance of COVID-19 vaccination for patients on immunosuppressive (IS) medication has increased due to the high risk of severe disease or mortality. Different vaccines have varying efficacy rates against symptomatic COVID-19, ranging from 46.8% to 95%. The objective of this study was to examine the differences in anti-Spike IgG, anti-Spike IgA, and neutralizing antibody (NAb) activity between the inactive CoronaVac vaccine and the mRNA-based BNT162b2 vaccine in IS patients.MethodA total of 441 volunteers, including 104 IS patients, 263 healthy controls (HC), who received two doses of CoronaVac or BNT162b2, and 74 unvaccinated patients with a history of SARS-CoV-2 infection, were included in the study. Anti-spike IgG, IgA, and NAb activity were investigated.ResultsImmunogenicity with BNT162b2 was higher than with CoronaVac, but in IS groups, it was lower than HC (CoronaVac-IS: 79.3%, CoronaVac-HC: 96.5%, p < 0.001; BNT162b2-IS: 91.3%, BNT162b2-HC: 100%, p = 0.005). With CoronaVac, anti-Spike IgG levels were significantly lower than BNT162b2 (CoronaVac-IS: 234.5AU/mL, CoronaVac-HC: 457.85AU/mL; BNT162b2-IS: 5311.2AU/mL, BNT162b2-HC: 8842.8AU/mL). NAb activity in the BNT162b2 group was significantly higher. NAb and anti-Spike IgG levels were found to be correlated. Among the IS group, a significantly lower response to the vaccines was observed when using rituximab. IgA levels were found to be lower with CoronaVac.ConclusionsAlthough immunogenicity was lower in IS patients, an acceptable response was obtained with both vaccines, and significantly higher anti-Spike IgG, anti-Spike IgA, and NAb activity levels were obtained with BNT162b2.
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    Evaluation of Biomarkers and Severity of COVID-19 in A Single Center
    (Aydın Ece, 17 Eylül 2022) Yalçın, Demet; Iğnak, Şeyda; Uluışık, Işılsu Ezgi; Çeçen, Olida; Sonkaya, Muhammed Mert; Demirel, Özlem Unay
    Objectives: The clinical course of COVID-19 ranges from mild to severe. The predictability of clinical outcomes gains importance in managing the disease. In this retrospective cohort study, we aimed to investigate the relationship between biomarker levels and the clinical severity of COVID-19. Methods: COVID-19 patients (n=618) admitted to a tertiary care hospital in Istanbul, Turkey were classified according to their clinical status using a scoring system designed by WHO. Laboratory parameters such as D-dimer, ferritin, and lymphocyte count levels were evaluated. In order to find out the relation between laboratory biomarkers and the severity of COVID-19, univariable and multivariable logistic regression analyses were used. Results: A positive correlation was found when WHO Score was compared with D-dimer levels (r=.508, p<0.01), and ferritin levels (r=.391, p<0.01), whereas a negative correlation was observed between WHO Score and lymphocyte count levels (r=-.381, p<0.01). The cut-off values for D-dimer and ferritin were found as 0.86 ng/mL (70.9% sensitivity and 87.1% specificity) and 92.74 ng/mL (78.5% sensitivity and 52.2% specificity) respectively. According to the multivariable logistic regression model, lymphocyte count (β=- 0.305, p<0.001) and D-dimer levels (β=1.326, p<0.001) are the statistically significant regressors for hospitalization need. Conclusion: Patients with higher D-dimer and ferritin levels were likely to have more severe disease, whereas patients with higher lymphocyte counts overcame the disease mildly. Unlike other studies, evaluating D-dimer and lymphocyte count will likely give more detailed information on COVID-19 clinical outcomes. J Microbiol Infect Dis 2022; 12(3):89-96.
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    RT-PCR cycle threshold (Ct) values predicting COVID-19 patients' outcome
    (BAYRAKOL, 2022) İğnak, Seyda; Yalçın, Demet; Çeçen, Olida; Sonkaya, Muhammed Mert; Uluışık, Işılsu Ezgi; Demirel, Özlem Unay
    Aim: Clinical presentation of COVID-19 ranges from asymptomatic to fatal cases. Therefore, predictability of prognosis gains importance in managing the disease. The aim of this study is to investigate the relation between RT-PCR cycle threshold (Ct) values and the clinical severity of COVID-19 infection. Material and Methods: A retrospective study was conducted among 1224 COVID-19 patients. A scoring system, which is designed by the World Health Organization was used to classify patients by means of their clinical status. Results: The cut-off for Ct value in ROC curves was 21.52 at the point, when the COVID-19 patient clinic is shifting from ambulatory to hospitalized (79.7% sensitivity, 69% specificity). A significant weak positive correlation was found between age and WHO Score (r= .238 p<0.01) and a significant weak negative correlation was found between Ct value and WHO Score (r=-.068 p<0.05) in COVID-19 patients. Discussion: Patients with lower RT-PCR Ct values were more likely to go through the disease more severely due to higher virulence. Reporting of numerical Ct values may help clinicians in terms of prognosis.