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Confusion and Thinking on the Diagnosis and Treatment of Patients with Negative RT-PCR Results for SARS-CoV-2

28 Pages Posted: 17 Mar 2020

See all articles by Liang Guo

Liang Guo

Wuhan University - Department of Plastic Surgery

Yihui Huang

Wuhan University - Department of Plastic Surgery

Mengqi Tu

Wuhan University - Department of Radiology

Shipei Wang

Wuhan University - Department of Plastic Surgery

Sichao Chen

Wuhan University - Department of Plastic Surgery

Wei Long

Wuhan University - Department of Plastic Surgery

Wei Zhou

Wuhan University - Department of Plastic Surgery

Danyang Chen

Wuhan University - Department of Plastic Surgery

Lin Zhou

Wuhan University - Department of Plastic Surgery

Min Wang

Wuhan University - Department of Plastic Surgery

Meng Wu

Wuhan University - Department of Ultrasound

Qi Huang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - NHC Key Laboratory of Pulmonary Diseases

Haibo Xu

Wuhan University - Department of Radiology

Wen Zeng

Wuhan University - Department of Ophthalmology

Zeming Liu

Wuhan University - Department of Plastic Surgery

More...

Abstract

Background: A novel type of coronavirus (SARS-CoV-2) with unclear origin first appeared in Wuhan in December, 2019, showing human-to-human transmission. Adopting proper treatment and management for patients who have negative results in SARS-CoV-2 laboratory tests but typical imaging is also a great challenge that clinicians are facing.

Methods: Retrospective, single center study was conducted for a cohort of patients who were diagnosed with novel coronavirus–infected pneumonia and admitted to Zhongnan Hospital of Wuhan University during the period December, 2019, to January, 2020. A total of 149 patients who were diagnosed with novel coronavirus–infected pneumonia was enrolled and a cohort of 100 patients was left after exclusion. 10 patients were included in the negative group and 90 patients were included in the positive group.

Findings: There was a higher percentage of patients with negative RT-PCR results with comorbidities than there were with positive results (P = 0.041), and significant statistical differences in laboratory findings between the positive and negative groups were seen only for C-reactive protein (P = 0.028). As for other features, patients with negative results for RT-PCR showed no differences compared with those with positive results.

Interpretation: Patients with negative RT-PCR results with symptoms and apparent SARS-CoV-2 infection on chest radiographs had higher levels of C-reactive protein and were more likely to have comorbidities than those with positive results. Low detection efficiency of viral nucleic acid might be related to the similarities in features of the two groups. Clinicians should be aware that the condition of negative patients with high levels of CRP might deteriorate and further investigations regarding the efficiency of SARS-CoV-2 detection are needed.

Funding Statement: None.

Declaration of Interests: The authors declare that there is no conflict of interest regarding the publication of this article.

Ethics Approval Statement: This single center, retrospective study was approved by the Institutional Ethics Board of Zhongnan Hospital of Wuhan University (approval number 2020015).

Keywords: COVID-19; SARS-CoV-2; Negative RT-PCR Result

Suggested Citation

Guo, Liang and Huang, Yihui and Tu, Mengqi and Wang, Shipei and Chen, Sichao and Long, Wei and Zhou, Wei and Chen, Danyang and Zhou, Lin and Wang, Min and Wu, Meng and Huang, Qi and Xu, Haibo and Zeng, Wen and Liu, Zeming, Confusion and Thinking on the Diagnosis and Treatment of Patients with Negative RT-PCR Results for SARS-CoV-2 (3/4/2020). Available at SSRN: https://ssrn.com/abstract=3551322 or http://dx.doi.org/10.2139/ssrn.3551322

Liang Guo

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Yihui Huang

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Mengqi Tu

Wuhan University - Department of Radiology

China

Shipei Wang

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Sichao Chen

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Wei Long

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Wei Zhou

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Danyang Chen

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Lin Zhou

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Min Wang

Wuhan University - Department of Plastic Surgery

Wuhan, 430071
China

Meng Wu

Wuhan University - Department of Ultrasound

Wuhan, 430071
China

Qi Huang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - NHC Key Laboratory of Pulmonary Diseases

Wuhan
China

Haibo Xu

Wuhan University - Department of Radiology ( email )

China

Wen Zeng

Wuhan University - Department of Ophthalmology ( email )

Wuhan, 430071
China

Zeming Liu (Contact Author)

Wuhan University - Department of Plastic Surgery ( email )

Wuhan, 430071
China

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