{"id":25839,"date":"2022-11-17T11:50:57","date_gmt":"2022-11-17T08:50:57","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=25839"},"modified":"2022-12-26T19:47:34","modified_gmt":"2022-12-26T16:47:34","slug":"sars-cov-2-varyantlarinin-prevalansi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2022\/11\/17\/sars-cov-2-varyantlarinin-prevalansi\/","title":{"rendered":"COVID-19 Pozitif Hastalarda SARS-CoV-2 Varyantlar\u0131n\u0131n Prevalans\u0131"},"content":{"rendered":"

G\u0130R\u0130\u015e<\/h2>\n

Aral\u0131k 2019\u2019da \u00c7in\u2019in Vuhan kentinde ortaya \u00e7\u0131kan ve etyolojisi bilinmeyen pn\u00f6moni olgular\u0131yla ba\u015flayan salg\u0131n\u0131n etkeni yeni bir koronavirus olarak tan\u0131mlanm\u0131\u015ft\u0131r. Bug\u00fcne dek insanl\u0131\u011f\u0131 en \u00e7ok etkileyen \u00fc\u00e7 koronavirus, 2002\u2019de SARS-CoV, 2012\u2019de MERS-CoV ve 2019\u2019da mevcut COVID-19 etkeni olan SARS-CoV-2 olup hepsi de salg\u0131nlara neden olmu\u015ftur. SARS-CoV-2, Coronaviridae<\/i> ailesinin Betacoronavirus <\/i>cinsinde s\u0131n\u0131fland\u0131r\u0131lan, zarfl\u0131 ve pozitif polariteli bir RNA virusudur. N\u00fckleokapsid (N), zarf (E), membran (M) ve \u201cspike\u201d (S) ad\u0131 verilen ta\u00e7 \u015feklindeki y\u00fczey antijenlerinin yan\u0131 s\u0131ra \u00e7e\u015fitli yard\u0131mc\u0131 ve yap\u0131sal olmayan proteinlere de (\u201cnonstructural protein \u2013 NSP\u201d) sahiptir. SARS-CoV-2\u2019nin replikasyonu s\u0131ras\u0131nda varyasyonlar kendili\u011finden meydana gelir ancak mutasyon s\u0131kl\u0131\u011f\u0131, NSP14 ekzoribon\u00fckleaz aktivitesi nedeniyle di\u011fer RNA viruslar\u0131na k\u0131yasla nispeten d\u00fc\u015f\u00fckt\u00fcr (1). COVID-19 hastal\u0131\u011f\u0131n\u0131n zoonotik oldu\u011fu d\u00fc\u015f\u00fcn\u00fclmekle birlikte \u015fu ana kadar hayvan rezervuar\u0131 kesin olarak belirlenememi\u015ftir.\u00a0 <\/span>\u0130nsandan insana ana bula\u015f yolu damlac\u0131k ile bula\u015ft\u0131r; kontamine y\u00fczeylere temas etmi\u015f ellerin burun, g\u00f6z mukozas\u0131 ile temas\u0131 sonras\u0131nda da bula\u015f g\u00f6r\u00fclebilir (2). Etken virusun t\u00fcm d\u00fcnyaya h\u0131zla yay\u0131lmas\u0131yla D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) taraf\u0131ndan 11 Mart 2020 tarihinde pandemi ilan edilmi\u015f ve Uluslararas\u0131 Virus Taksonomisi Komitesi (\u201cInternational Committee on Taxonomy of Viruses \u2013 ICTV\u201d) etkeni, \u015fiddetli akut solunum yolu sendromu koronavirus 2 (\u201csevere acute respiratory syndrome coronavirus \u2013 SARS-CoV-2\u201d) olarak adland\u0131rm\u0131\u015ft\u0131r. Ayn\u0131 tarihte, T\u00fcrkiye\u2019den ilk olgu bildirimi yap\u0131lm\u0131\u015ft\u0131r (3, 4). DS\u00d6 verilerine g\u00f6re, 23 Mart 2022 tarihi itibar\u0131yla d\u00fcnya genelinde COVID-19 nedenli 470 839 745 olgu ve 6 092 933 \u00f6l\u00fcm do\u011frulanm\u0131\u015ft\u0131r (5). Pandeminin ba\u015flang\u0131c\u0131ndan itibaren SARS-CoV-2\u2019ye kar\u015f\u0131 bir\u00e7ok a\u015f\u0131 \u00e7al\u0131\u015fmas\u0131 ve akabinde uygulamas\u0131 ba\u015flam\u0131\u015ft\u0131r. Ancak bu zaman diliminde halk sa\u011fl\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan endi\u015fe yaratan bir\u00e7ok yeni SARS-CoV-2 varyant\u0131 ortaya \u00e7\u0131km\u0131\u015ft\u0131r. DS\u00d6, 31 May\u0131s 2021\u2019de Yunan alfabesinin harflerini kullanarak kolay ve ak\u0131lda kal\u0131c\u0131 bir etiketlemeyle varyantlar\u0131 isimlendirmi\u015ftir (6). Pandemi s\u00fcrecinde ortaya \u00e7\u0131kan varyantlarla birlikte, etkenin bula\u015f riskinin artmas\u0131, imm\u00fcn yan\u0131ttan ka\u00e7\u0131\u015f, reinfeksiyon riski, a\u015f\u0131lar\u0131n etkinli\u011finin d\u00fc\u015fmesi ve klinik tablonun a\u011f\u0131rla\u015fmas\u0131 pandemi seyrini olumsuz y\u00f6nde etkileyebilecek tehditlerdir. Bu y\u00fczden COVID-19 pandemisiyle m\u00fccadelede SARS-CoV-2 varyantlar\u0131n\u0131 saptamak ve ge\u00e7irdi\u011fi mutasyonlar\u0131 takip etmek kritik bir \u00f6neme sahiptir. DS\u00d6 taraf\u0131ndan; alfa (B.1.1.7), beta (B.1.351), gamma (P.1), delta (B.1.617.2) ve omicron (B.1.1.529) endi\u015fe verici varyantlar (\u201cvariants of concern \u2013 VOCs\u201d) olarak s\u0131n\u0131fland\u0131r\u0131lmaktad\u0131r (7).\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fmam\u0131zda, COVID-19 ger\u00e7ek zamanl\u0131 polimeraz zincir reaksiyonu (\u201creal-time polymerase chain reaction \u2013 RT-PCR\u201d) testi pozitif olan hastalarda SARS-CoV-2 VOCs\u2019un da\u011f\u0131l\u0131m\u0131n\u0131n geriye d\u00f6n\u00fck olarak irdelenmesi ama\u00e7land\u0131.<\/span><\/p>\n

Y\u00d6NTEMLER<\/h2>\n

Nisan 2021-31 Aral\u0131k 2021 tarihleri aras\u0131nda COVID-19 PCR test istemiyle klinik \u00f6rnekleri g\u00f6nderilen 4260 hasta \u00e7al\u0131\u015fmaya dahil edildi. \u00d6rnekleri de\u011ferlendirilen hastalar\u0131n 2173 (%51)\u2019\u00fc erkek 2087 (%49)\u2019si kad\u0131nd\u0131. Nazofarengeal s\u00fcr\u00fcnt\u00fc, bronkoalveolar lavaj, trakeal aspirat \u00f6rnekleri viral n\u00fckleik asit tamponu (vNAT) ile muamele edilerek viral n\u00fckleik asit izolasyonu ger\u00e7ekle\u015ftirildi.<\/p>\n

SARS-CoV-2 varyantlar\u0131; ORF1ab ve N gen b\u00f6lgelerinin yan\u0131 s\u0131ra yaln\u0131zca B.1.1.7, B.1.351 ve P.1\u2019de bulunan varyant spesifik genom b\u00f6lgelerini de hedefleyen Bio-Speedy\u00ae<\/span> SARS-CoV-2 Variant Plus kiti (Bioeksen AR-GE Teknolojileri, T\u00fcrkiye) ile saptand\u0131. Alfa varyant\u0131 tespiti i\u00e7in N D3L mutasyonunu, delta varyant\u0131n\u0131n tespiti i\u00e7in S L452R mutasyonunu ve \u00e7o\u011funlukla gamma ve mu varyantlar\u0131nda g\u00f6r\u00fclen S E484K mutasyonunu hedefleyen Bio-Speedy\u00ae<\/span> SARS-CoV-2 Emerging Plus kiti (Bioeksen Ar-Ge Teknolojileri, T\u00fcrkiye) ve CFX96 DX Real-Time PCR sistemleri (Bio-Rad Laboratories, ABD) kullan\u0131ld\u0131. \u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fma i\u00e7in Medipol \u00dcniversitesi Giri\u015fimsel Olmayan Klinik Ara\u015ft\u0131rmalar Etik Kurulu\u2019ndan 17 \u015eubat 2022 tarih ve 157 karar numaras\u0131yla onay al\u0131nd\u0131. Ayr\u0131ca T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Sa\u011fl\u0131k Hizmetleri Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc Bilimsel \u00c7al\u0131\u015fma Platformu\u2019ndan da 2022-02-04T13_08_28 ba\u015fvuru numaras\u0131yla 5 \u015eubat 2022 tarihinde izin al\u0131nd\u0131.\u00a0<\/span><\/p>\n

\u0130statistiksel Analiz\u00a0<\/span><\/h3>\n

\u0130statistiksel analiz SPSS 22.0 program\u0131 (IBM Corp., Armonk, NY, ABD) kullan\u0131larak yap\u0131ld\u0131. Verilerin analizinde; frekans (n), y\u00fczde (%) ve ortalama de\u011ferler belirlendi. Normal da\u011f\u0131l\u0131ma uygunluk i\u00e7in Kolmogorov-Smirnov testi uyguland\u0131 (n>30).\u00a0<\/span><\/p>\n

BULGULAR<\/h2>\n
\"\"<\/a>

Tablo 1.<\/strong> COVID-19 PCR Testi \u00c7al\u0131\u015f\u0131lan \u00d6rneklerin ve Pozitif Hastalar\u0131n Kar\u015f\u0131la\u015ft\u0131rmas\u0131<\/p><\/div>\n

\"\"<\/a>

Tablo 2.<\/strong> Pozitif Olgularda Varyant Tiplerinin Da\u011f\u0131l\u0131m\u0131<\/p><\/div>\n

\u00c7al\u0131\u015fmaya dahil edilen 4260 hastan\u0131n ya\u015f ortalamas\u0131 39.82\u00b118.98 (medyan=36) olup bunlar\u0131n 2173 (%51)\u2019\u00fc erkek, 2087 (%49)\u2019si kad\u0131nd\u0131. \u00d6rneklerin 773 (%18.14)\u2019\u00fcnde SARS-CoV-2 RT-PCR pozitifli\u011fi, pozitif \u00f6rneklerin 316 (%40.88)\u2019s\u0131nda ise farkl\u0131 SARS-CoV-2 varyantlar\u0131 saptand\u0131. PCR testi pozitif hastalar\u0131n 407 (%52.65)\u2019si kad\u0131n, 366 (%47.35)\u2019s\u0131 erkek, ya\u015f ortalamas\u0131 41.71\u00b119.32 idi. Hastalar\u0131n 457 (%59.12)\u2019sinde herhangi bir varyant saptanmazken 156 (%20.18)\u2019s\u0131nda alfa, 137 (%17.72)\u2019sinde ise delta varyant\u0131 saptand\u0131. Beta, gamma ve di\u011fer \u015f\u00fcpheli varyantlar\u0131n yay\u0131l\u0131m\u0131n\u0131n g\u00f6rece d\u00fc\u015f\u00fck oranlarda kald\u0131\u011f\u0131 g\u00f6r\u00fcld\u00fc (Tablo 1, 2).\u00a0<\/span><\/p>\n

\u0130RDELEME<\/h2>\n

T\u00fcm d\u00fcnyada SARS-CoV-2 ve varyantlar\u0131n\u0131n neden oldu\u011fu pandemi b\u00fcy\u00fck bir endi\u015fe kayna\u011f\u0131d\u0131r. <\/b>Bu y\u00fczden, virusun y\u00fcksek frekansla dola\u015f\u0131mda oldu\u011fu yerlerde SARS-CoV-2 mutasyonlar\u0131 nedeniyle ortaya \u00e7\u0131kan yeni varyantlar\u0131n s\u0131kl\u0131\u011f\u0131n\u0131n saptanmas\u0131 ve genomik analizlerinin yap\u0131lmas\u0131 pandemi y\u00f6netimi ve al\u0131nacak \u00f6nlemler a\u00e7\u0131s\u0131ndan kritik \u00f6neme sahiptir (6). COVID-19 pandemisiyle m\u00fccadelede SARS-CoV-2 genomundaki mutasyonlar\u0131 ve\/veya varyasyonlar\u0131 takip ve analiz etmek pandeminin seyri a\u00e7\u0131s\u0131ndan \u00f6nemlidir. Bununla birlikte, mutasyonlar viruslar\u0131n ya\u015fam d\u00f6ng\u00fclerinin do\u011fal bir par\u00e7as\u0131 olup salg\u0131nlar\u0131n seyrini olumsuz y\u00f6nde etkilemeleri nadir ve s\u0131n\u0131rl\u0131d\u0131r. Bu kapsamda, mutasyonlar\u0131n mevcut salg\u0131nlar\u0131n y\u00f6netiminde ve yeni salg\u0131nlar\u0131n anla\u015f\u0131lmas\u0131nda yard\u0131mc\u0131 olabilece\u011fi d\u00fc\u015f\u00fcn\u00fclmektedir (6, 7).<\/p>\n

COVID-19 tan\u0131s\u0131nda hen\u00fcz alt\u0131n standart olarak kabul edilen bir test olmasa da RT-PCR testlerinin \u00f6zellikle erken d\u00f6nemde %70\u2019e kadar duyarl\u0131 oldu\u011fu, ge\u00e7 d\u00f6nemde PCR testlerindeki duyarl\u0131l\u0131\u011f\u0131n azald\u0131\u011f\u0131 ancak bu d\u00f6nemde de antikor testlerinin tan\u0131daki duyarl\u0131l\u0131\u011f\u0131n\u0131n artt\u0131\u011f\u0131 bildirilmi\u015ftir (8, 9). Bununla birlikte RT-PCR testleri SARS-CoV-2 tan\u0131s\u0131nda en yayg\u0131n kullan\u0131lan ve \u00f6nerilen y\u00f6ntem olarak kabul g\u00f6rmektedir.\u00a0<\/span><\/p>\n

DS\u00d6, tan\u0131da E ve RdRp genlerinin birlikte hedeflenmesini \u00f6nerirken, ABD Hastal\u0131k Kontrol ve Korunma Merkezleri (\u201cCenters for Disease Control and Prevention \u2013 CDC\u201d), N1 ve N2 genlerinin hedeflenmesini \u00f6nermektedir.<\/span><\/p>\n

\u00c7in\u2019de ORF1ab ve N genleri, Almanya\u2019da RdRp, E ve N genleri, Fransa\u2019da RdRp geni \u00fczerinde iki hedef b\u00f6lge, Tayland\u2019da ise N geni hedef gen b\u00f6lgesi olarak kullan\u0131lmaktad\u0131r. \u00dclkemizde pandeminin ilk d\u00f6nemlerinde yayg\u0131n olarak RdRp geni hedeflenirken, g\u00fcn\u00fcm\u00fczde ORF1ab ve N geninin hedef b\u00f6lge olarak al\u0131nd\u0131\u011f\u0131 testler kullan\u0131lmaktad\u0131r (10). \u00c7al\u0131\u015fmam\u0131zda, ORF1ab, N ve E gen b\u00f6lgeleri hedeflenerek SARS-CoV-2 pozitifli\u011fi saptand\u0131.<\/p>\n

\"\"

\u015eekil 1.<\/strong> Aylara G\u00f6re Pozitiflik Oranlar\u0131n\u0131n ve Pozitif Vakalar \u0130\u00e7erisindeki Varyantlar\u0131n Da\u011f\u0131l\u0131m\u0131<\/p><\/div>\n

S<\/span>ARS-CoV-2 varyantlar\u0131n\u0131n genomik ara\u015ft\u0131rmalar\u0131nda \u00f6ncelikli olarak n\u00f6tralizan antikorlar\u0131n ana hedefi olan \u201cspike\u201d glikoproteinindeki mutasyonlara odaklan\u0131lm\u0131\u015ft\u0131r. Yeni bir varyant, \u201cspike\u201d antijeninde bula\u015f\u0131c\u0131l\u0131\u011f\u0131n\u0131 art\u0131ran bir veya birden fazla mutasyona sahipse bu varyant di\u011fer varyantlarla rekabet edebilir ve dola\u015f\u0131mdaki di\u011fer varyantlar i\u00e7in de bask\u0131n hale gelebilir (11). \u00c7al\u0131\u015fmam\u0131zda, Nisan, May\u0131s ve Haziran 2021 d\u00f6neminde alfa varyant\u0131 bask\u0131n olarak saptan\u0131rken, Temmuz ay\u0131ndan itibaren delta varyant\u0131n\u0131n bask\u0131n hale geldi\u011fi saptand\u0131. K\u00fcresel olarak dola\u015f\u0131mdaki varyantlar\u0131 bask\u0131layan delta (B.1.617.2) varyant\u0131n\u0131n \u00f6nceki varyantlardan daha bula\u015f\u0131c\u0131 oldu\u011fu bildirilmi\u015ftir (12). DS\u00d6 taraf\u0131ndan VOCs\u2019lardan biri olarak tan\u0131mlanan delta varyant\u0131n\u0131n bula\u015fma h\u0131z\u0131n\u0131n, orijinal virusa g\u00f6re yakla\u015f\u0131k iki kat fazla oldu\u011fu hesaplanm\u0131\u015ft\u0131r (12, 13). \u00c7al\u0131\u015fmam\u0131zda da delta varyant\u0131n\u0131n Temmuz 2021 itibar\u0131yla \u00fclkemizde bask\u0131n hale gelen varyant oldu\u011fu g\u00f6r\u00fclmektedir (\u015eekil 1).<\/p>\n

Ortaya \u00e7\u0131kan yeni varyantlar, sadece bula\u015f\u0131c\u0131l\u0131\u011f\u0131n artmas\u0131yla veya morbidite ve mortaliteyle ili\u015fkili de\u011fildir. Ayn\u0131 zamanda tan\u0131sal testlerden ka\u00e7abilme yetene\u011fine, antiviral tedavilerde azalm\u0131\u015f duyarl\u0131l\u0131\u011fa, daha \u00f6nce infeksiyonu atlatm\u0131\u015f ve a\u015f\u0131lanm\u0131\u015f bireylerde yeniden infeksiyona neden olma kapasitesine sahip olabilirler. Virus ne kadar uzun s\u00fcre yay\u0131l\u0131rsa mutasyon \u015fans\u0131 da o kadar y\u00fckselmektedir (14). Varyantlar\u0131n imm\u00fcn sistemden ka\u00e7ma yetene\u011fi; mevcut ve potansiyel gelecekteki varyantlara kar\u015f\u0131 geni\u015f \u00f6l\u00e7\u00fcde n\u00f6tralize edici aktivite g\u00f6steren yeni nesil a\u015f\u0131lar\u0131n geli\u015ftirilmesini bir \u00f6ncelik haline getirmi\u015ftir. Hem halk sa\u011fl\u0131\u011f\u0131 \u00f6nlemleri hem de a\u015f\u0131lar\u0131n adil ve yayg\u0131n uygulanmas\u0131 ile viral replikasyonun bask\u0131lanmas\u0131, yeni varyantlar\u0131n ortaya \u00e7\u0131kma riskinin azalt\u0131lmas\u0131nda kritik \u00f6neme sahiptir (15).<\/p>\n

Pandemi s\u00fcrecinde ortaya \u00e7\u0131kacak yeni varyantlar\u0131n fenotiplerini, infektivite, bula\u015f yetene\u011fi, virulans ve antijenisite a\u00e7\u0131s\u0131ndan anlamak \u00f6nemlidir. \u0130leriye d\u00f6n\u00fck olarak, bug\u00fcne kadar ortaya \u00e7\u0131kan SARS-CoV-2 \u201cspike\u201d mutasyonlar\u0131n\u0131n deneysel karakterizasyonu ve genomik analizleri, dola\u015f\u0131mdaki viruslarda hen\u00fcz g\u00f6r\u00fclmemi\u015f olabilecek mutasyonlar veya mutasyon kombinasyonlar\u0131 hakk\u0131nda son derece yararl\u0131 bilgiler sa\u011flayacakt\u0131r (16).<\/p>\n

\u00dclkemizdeki SARS-CoV-2 varyantlar\u0131n\u0131n da\u011f\u0131l\u0131m\u0131 ve analizleri T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Halk Sa\u011fl\u0131\u011f\u0131 Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc taraf\u0131ndan yap\u0131lmakla birlikte; alfa, beta, gamma, delta, lambda, mu ve omicron gibi bir\u00e7ok varyat\u0131n \u00fclkemizdeki varl\u0131\u011f\u0131 farkl\u0131 \u00e7al\u0131\u015fmalarda da bildirilmi\u015ftir. \u00c7al\u0131\u015fmam\u0131zda, alfa ve delta varyantlar\u0131n\u0131n bask\u0131n olarak saptand\u0131\u011f\u0131 d\u00f6nemin sona ermesiyle 2021 sonlar\u0131nda artan di\u011fer varyant \u015f\u00fcpheli olgular \u00e7o\u011fu \u00fclkede geni\u015f yay\u0131l\u0131m g\u00f6steren omicron varyant\u0131n\u0131 d\u00fc\u015f\u00fcnd\u00fcrmektedir. Bildi\u011fimiz kadar\u0131yla \u00e7al\u0131\u015fmam\u0131z, \u00fclkemizdeki varyantlar\u0131n prevalans\u0131na dair yay\u0131mlanm\u0131\u015f ilk \u00e7al\u0131\u015fma olup epidemiyolojik veriler \u0131\u015f\u0131\u011f\u0131nda planlanm\u0131\u015f, b\u00f6lgesel ve k\u00fcresel \u00e7apta varyantlar\u0131n s\u0131kl\u0131\u011f\u0131n\u0131 ve genomik analizlerini irdeleyen molek\u00fcler s\u00fcrveyans \u00e7al\u0131\u015fmalar\u0131n\u0131n yap\u0131lmas\u0131 gerekmektedir.<\/p>\n

\u00d6rneklemimiz geni\u015f tutulmakla birlikte tek merkezli bir \u00e7al\u0131\u015fma olmas\u0131 \u00e7al\u0131\u015fmam\u0131z\u0131n en \u00f6nemli k\u0131s\u0131tl\u0131l\u0131\u011f\u0131d\u0131r. Ayr\u0131ca, \u00f6rnekleri \u00e7al\u0131\u015f\u0131lan hastalar\u0131n komorbiditeleri, servis bilgileri gibi ek parametrelere de ula\u015f\u0131lamam\u0131\u015ft\u0131r. Omicron varyant\u0131na y\u00f6nelik tan\u0131sal testlerin yap\u0131lamamas\u0131 da bir di\u011fer \u00f6nemli k\u0131s\u0131tl\u0131l\u0131kt\u0131r.<\/p>\n

Sonu\u00e7 olarak; t\u00fcm d\u00fcnyada uygulanan birbirinden farkl\u0131 k\u0131s\u0131tlamalarla insidans\u0131n dalgalanmas\u0131, reinfeksiyon riski, virusun yeni mutasyonlara a\u00e7\u0131k olmas\u0131 ve a\u015f\u0131lama kampanyalar\u0131ndaki h\u0131zlanmalar ve yava\u015flamalar gibi nedenlerle pandemi s\u00f6n\u00fcmleme zaman\u0131n\u0131n tahmini g\u00fc\u00e7le\u015fmektedir (17). COVID-19 pandemisi s\u00fcresince edindi\u011fimiz tecr\u00fcbelerin yan\u0131 s\u0131ra mevcut varyantlar\u0131n yay\u0131l\u0131m\u0131 ve genomik analizlerine dair yap\u0131lacak \u00e7al\u0131\u015fmalar meydana gelebilecek potansiyel salg\u0131nlara kar\u015f\u0131 daha haz\u0131rl\u0131kl\u0131 olabilmemize olanak sa\u011flayacakt\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e Aral\u0131k 2019\u2019da \u00c7in\u2019in Vuhan kentinde ortaya \u00e7\u0131kan ve etyolojisi bilinmeyen pn\u00f6moni olgular\u0131yla ba\u015flayan salg\u0131n\u0131n etkeni yeni bir koronavirus olarak tan\u0131mlanm\u0131\u015ft\u0131r. Bug\u00fcne dek insanl\u0131\u011f\u0131 en \u00e7ok etkileyen \u00fc\u00e7 koronavirus, 2002\u2019de SARS-CoV, 2012\u2019de MERS-CoV ve 2019\u2019da mevcut COVID-19 etkeni olan SARS-CoV-2 olup hepsi de salg\u0131nlara neden olmu\u015ftur. SARS-CoV-2, Coronaviridae ailesinin Betacoronavirus cinsinde s\u0131n\u0131fland\u0131r\u0131lan, zarfl\u0131 ve pozitif […]<\/p>\n","protected":false},"author":4,"featured_media":26265,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[5540,5174,5541,5542,5189],"class_list":["post-25839","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ozgun-arastirma","tag-alfa-varyanti","tag-covid-19","tag-delta-varyanti","tag-endise-verici-varyantlar","tag-sars-cov-2"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/25839","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=25839"}],"version-history":[{"count":4,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/25839\/revisions"}],"predecessor-version":[{"id":26270,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/25839\/revisions\/26270"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media\/26265"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=25839"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=25839"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=25839"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}