tetano
Editor, Senior Moderator
J Clin Med
. 2020 Sep 18;9(9):E3014.
doi: 10.3390/jcm9093014.
Patients with Initial Negative RT-PCR and Typical Imaging of COVID-19: Clinical Implications
Florent Baicry[SUP] 1 [/SUP], Pierrick Le Borgne[SUP] 1 2 [/SUP], Thibaut Fabacher[SUP] 3 [/SUP], Martin Behr[SUP] 1 [/SUP], Elena Laura Lemaitre[SUP] 1 [/SUP], Paul-Albert Gayol[SUP] 1 [/SUP], S?bastien Harscoat[SUP] 1 [/SUP], Nirvan Issur[SUP] 1 [/SUP], Sabrina Garnier-Kepka[SUP] 1 [/SUP], Mickael Ohana[SUP] 4 [/SUP], Pascal Bilbault[SUP] 1 2 [/SUP], Mathieu Oberlin[SUP] 1 5 [/SUP]
Affiliations
Abstract
The sensitivity of reverse transcriptase polymerase chain reaction (RT-PCR) has been questioned due to negative results in some patients who were strongly suspected of having coronavirus disease 2019 (COVID-19). The aim of our study was to analyze the prognosis of infected patients with initial negative RT-PCR in the emergency department (ED) during the COVID-19 outbreak. This study included two cohorts of adult inpatients admitted into the ED. All patients who were suspected to be infected with SARS-CoV-2 and who underwent a typical chest CT imaging were included. Thus, we studied two distinct cohorts: patients with positive RT-PCR (PCR+) and those with negative initial RT-PCR (PCR-). The data were analyzed using Bayesian methods. We included 66 patients in the PCR- group and 198 in the PCR+ group. The baseline characteristics did not differ except in terms of a proportion of lower chronic respiratory disease in the PCR- group. We noted a less severe clinical presentation in the PCR- group (lower respiratory rate, lower oxygen need and mechanical ventilation requirement). Hospital mortality (9.1% vs. 9.6%) did not differ between the two groups. Despite an initially less serious clinical presentation, the mortality of patients infected by SARS-CoV-2 with a negative RT-PCR did not differ from those with positive RT-PCR.
Keywords: Bayesian analysis; COVID-19; clinical management; reverse transcriptase polymerase chain reaction.
. 2020 Sep 18;9(9):E3014.
doi: 10.3390/jcm9093014.
Patients with Initial Negative RT-PCR and Typical Imaging of COVID-19: Clinical Implications
Florent Baicry[SUP] 1 [/SUP], Pierrick Le Borgne[SUP] 1 2 [/SUP], Thibaut Fabacher[SUP] 3 [/SUP], Martin Behr[SUP] 1 [/SUP], Elena Laura Lemaitre[SUP] 1 [/SUP], Paul-Albert Gayol[SUP] 1 [/SUP], S?bastien Harscoat[SUP] 1 [/SUP], Nirvan Issur[SUP] 1 [/SUP], Sabrina Garnier-Kepka[SUP] 1 [/SUP], Mickael Ohana[SUP] 4 [/SUP], Pascal Bilbault[SUP] 1 2 [/SUP], Mathieu Oberlin[SUP] 1 5 [/SUP]
Affiliations
- PMID: 32962092
- DOI: 10.3390/jcm9093014
Abstract
The sensitivity of reverse transcriptase polymerase chain reaction (RT-PCR) has been questioned due to negative results in some patients who were strongly suspected of having coronavirus disease 2019 (COVID-19). The aim of our study was to analyze the prognosis of infected patients with initial negative RT-PCR in the emergency department (ED) during the COVID-19 outbreak. This study included two cohorts of adult inpatients admitted into the ED. All patients who were suspected to be infected with SARS-CoV-2 and who underwent a typical chest CT imaging were included. Thus, we studied two distinct cohorts: patients with positive RT-PCR (PCR+) and those with negative initial RT-PCR (PCR-). The data were analyzed using Bayesian methods. We included 66 patients in the PCR- group and 198 in the PCR+ group. The baseline characteristics did not differ except in terms of a proportion of lower chronic respiratory disease in the PCR- group. We noted a less severe clinical presentation in the PCR- group (lower respiratory rate, lower oxygen need and mechanical ventilation requirement). Hospital mortality (9.1% vs. 9.6%) did not differ between the two groups. Despite an initially less serious clinical presentation, the mortality of patients infected by SARS-CoV-2 with a negative RT-PCR did not differ from those with positive RT-PCR.
Keywords: Bayesian analysis; COVID-19; clinical management; reverse transcriptase polymerase chain reaction.