Clinical diagnosis of COVID-19 with consecutive negative molecular tests

Authors

  • Andrés Ramírez-Vélez Clínica CES
  • Sara Moreno Clínica CES
  • Giovanny Moncayo Clínica CES
  • Luisa Ramírez Clínica CES
  • Pablo Arango Clínica CES

DOI:

https://doi.org/10.21615/cesmedicina.34.COVID-19.14

Keywords:

Diagnostic test, COVID-19, SARS-CoV-2, false negative

Abstract

One of the difficulties within the current COVID-19 pandemic is the lack of specificity and sensitivity of diagnostic tests. Different societies have proposed diagnostic algorithms that include molecular tests, clinical symptoms, laboratory tests, and diagnostic imaging. In our setting, we use the RT-PCR in nasopharyngeal lavage, even knowing its limitations in terms of sensitivity. In this article, we present the case of a male patient in whom COVID-19 is confirmed even after multiple negative molecular tests. Keywords: Diagnostic test; CoVID-19; SARS-COV2; false negative. Introducción 

Downloads

Download data is not yet available.

References

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.

CDC. Information for Laboratories about Coronavirus (COVID-19) [Internet]. Centers for Disease Control and Prevention. 2020. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html

Zhou P, Yang X-L, Wang X-G, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3.

Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA. 2020;

Instituto Nacional de Salud. Orientaciones para la vigilancia en salud pública de la CoVID-19. 2020.

Saavedra Trujillo CH. Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID 19 en establecimientos de atención de la salud. Recomendaciones basadas en consenso de expertos e informadas en la evidencia. Infectio. 2020;24(3):1.

Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med. 2020;

Asociación Colombiana de Medicina Crítica y Cuidado Intensivo. Declaración del Consenso en Medicina Crítica para la atención multidisciplinaria del paciente con sospecha o confirmación diagnóstica Covid-19 [Internet]. 2020. Disponible en: http://www.amci.org.co/consenso-covid19

Huang P, Liu T, Huang L, Liu H, Lei M, Xu W, et al. Use of Chest CT in Combination with Negative RT-PCR Assay for the 2019 Novel Coronavirus but High Clinical Suspicion. Radiology. 2020;295(1):22-3.

Winichakoon P, Chaiwarith R, Liwsrisakun C, Salee P, Goonna A, Limsukon A, et al. Negative Nasopharyngeal and Oropharyngeal Swabs Do Not Rule Out COVID-19. McAdam AJ, editor. J Clin Microbiol. 2020;58(5).

Kumar S, Nyodu R, Maurya VK, Saxena SK. Morphology, Genome Organization, Replication, and Pathogenesis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). En: Saxena SK, editor. Coronavirus Disease 2019 (COVID-19): Epidemiology, Pathogenesis, Diagnosis, and Therapeutics. Springer; 2020. p. 23-31.

Al-Abdely HM, Midgley CM, Alkhamis AM, Abedi GR, Lu X, Binder AM, et al. Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia. Emerg Infect Dis. 2019;25(4):753-66.

To KK-W, Tsang OT-Y, Chik-Yan Yip C, Chan K-H, Wu T-C, Chan JMC, et al. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Dis. 2020;

To KK, Lu L, Yip CC, Poon RW, Fung AM, Cheng A, et al. Additional molecular testing of saliva specimens improves the detection of respiratory viruses. Emerg Microbes Infect. 2017;6(6):e49.

To KKW, Yip CCY, Lai CYW, Wong CKH, Ho DTY, Pang PKP, et al. Saliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: a diagnostic validity study. Clin Microbiol Infect. 2019;25(3):372-8.

Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020;296(2):E41-5.

Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol. 2020;30(6):3306-9.

Shi H, Han X, Zheng C. Evolution of CT Manifestations in a Patient Recovered from 2019 Novel Coronavirus (2019-nCoV) Pneumonia in Wuhan, China. Radiology.

Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT Imaging Fea-tures of 2019 Novel Coronavirus (2019-nCoV). Radiology. 2020;295(1):202-7.

Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for Radiologists on COVID-19: An Update. Radiology. 2020

Published

2020-06-12

How to Cite

Ramírez-Vélez, A., Moreno, S., Moncayo, G., Ramírez, L., & Arango, P. (2020). Clinical diagnosis of COVID-19 with consecutive negative molecular tests. CES Medicina, 34, 104–110. https://doi.org/10.21615/cesmedicina.34.COVID-19.14
Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views

Some similar items: