RT-PCR negative COVID-19

BMC Infectious Diseases

Michael Salvati¹  Magali Karagueuzian¹  Thomas Robin¹  Gaiane Demirdjian¹  Zhongjie Ma²  Stephanie Shiau²  Michael O’Shaughnessy³  Mitchell Hirsch³  Margaret Montovano³  Priyanshi Jain³  Abby Chopoorian⁴  Heta Parmar⁴  Padmapriya Banada⁴  Sri Ram Pentakota⁴  David Alland⁴  Kaheerman Saibire⁴  Yingda L. Xie⁴  Bhavana Patel⁵ 

[1] Beckman Coulter Inc.;Department of Biostatistics & Epidemiology, Rutgers School of Public Health;School of Medicine, Rutgers New Jersey Medical School;The Public Health Research Institute and the Department of Medicine, Rutgers New Jersey Medical School;University Hospital;

关键词: COVID-19;    SARS-CoV-2;    Suspects;    RT-PCR;    Diagnosis;   

DOI  :  10.1186/s12879-022-07095-x

来源: DOAJ

【 摘 要 】

Abstract Background COVID-19 is a multi-system infection with emerging evidence-based antiviral and anti-inflammatory therapies to improve disease prognosis. However, a subset of patients with COVID-19 signs and symptoms have repeatedly negative RT-PCR tests, leading to treatment hesitancy. We used comparative serology early in the COVID-19 pandemic when background seroprevalence was low to estimate the likelihood of COVID-19 infection among RT-PCR negative patients with clinical signs and/or symptoms compatible with COVID-19. Methods Between April and October 2020, we conducted serologic testing of patients with (i) signs and symptoms of COVID-19 who were repeatedly negative by RT-PCR (‘Probables’; N = 20), (ii) signs and symptoms of COVID-19 but with a potential alternative diagnosis (‘Suspects’; N = 15), (iii) no signs and symptoms of COVID-19 (‘Non-suspects’; N = 43), (iv) RT-PCR confirmed COVID-19 patients (N = 40), and (v) pre-pandemic samples (N = 55). Results Probables had similar seropositivity and levels of IgG and IgM antibodies as propensity-score matched RT-PCR confirmed COVID-19 patients (60.0% vs 80.0% for IgG, p-value = 0.13; 50.0% vs 72.5% for IgM, p-value = 0.10), but multi-fold higher seropositivity rates than Suspects and matched Non-suspects (60.0% vs 13.3% and 11.6% for IgG; 50.0% vs 0% and 4.7% for IgM respectively; p-values < 0.01). However, Probables were half as likely to receive COVID-19 treatment than the RT-PCR confirmed COVID-19 patients with similar disease severity. Conclusions Findings from this study indicate a high likelihood of acute COVID-19 among RT-PCR negative with typical signs/symptoms, but a common omission of COVID-19 therapies among these patients. Clinically diagnosed COVID-19, independent of RT-PCR positivity, thus has a potential vital role in guiding treatment decisions.

【 授权许可】

Unknown