Monitoring and detecting SARS-CoV-2 in Albanian Clinical Practice – The efficiency of CLIA serological assay, Real-Time PCR analysis and Biochemical analysis

Abstract

SARS – CoV-2 is a pathogenic coronavirus which continuously evolves as changes in the genetic code occur during the replication of the genome. To monitor and detect this infection a combination of 3 parameters is used in Albanian Clinical Practice. Real-Time PCR analysis is the main standard for the identification of SARS-CoV-2- infection. Because of the limits in its utilization for large-scale screening, serological assays have been used for detecting SARS-CoV-2 presence, accompanied by the monitoring level of White blood cells, Red blood cells and CRP (C-reactive Protein) check. This study aims to choose and highlight the best methodology and its efficiency in COVID-19 diagnostics. Nasopharyngeal samples were collected from 1198 patients which were analyzed after with RT-PCR. After 90 of these patients tested positive for SARS-CoV-2 virus blood samples were collected from them to perform biochemical analysis. Only 55 of them were subjected to CLIA serological assay. As a result, 49 (89.1%) patients were positive only for IgG, 4 (7.3%) patients were positive for both antibodies IgG and IgM and only 2(3.6%) patients were negative for both antibodies, based on serological results. The level of CRP varied from X- to 25.09 mg/L ad the most affected group of immunological cells were monocytes, lymphocytes, neutrophils along with red blood cells, hematocrit and hemoglobin. However, both molecular and biochemical assays had better performance 8-10 days after symptoms appearance, meanwhile, the serological assay was more predictable at least 10 days after symptoms appearance. In conclusion, the three methodologies used separately are limited in usefulness when diagnosing SARS-CoV-2 infection but a combination of them is the most effective way to diagnose this virus.