Confusion and Thinking on the Diagnosis and Treatment of Patients with Negative RT-PCR Results for SARS-CoV-2
28 Pages Posted: 17 Mar 2020More...
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
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