Academic Journal

Clinical, Laboratory, and Radiologic Characteristics of Patients With Initial False-Negative Severe Acute Respiratory Syndrome Coronavirus 2 Nucleic Acid Amplification Test Results

التفاصيل البيبلوغرافية
العنوان: Clinical, Laboratory, and Radiologic Characteristics of Patients With Initial False-Negative Severe Acute Respiratory Syndrome Coronavirus 2 Nucleic Acid Amplification Test Results
المؤلفون: Dugdale, Caitlin M, Anahtar, Melis N, Chiosi, John J, Lazarus, Jacob E, McCluskey, Suzanne M, Ciaranello, Andrea L, Gogakos, Tasos, Little, Brent P, Branda, John A, Shenoy, Erica S, Walensky, Rochelle P, Zachary, Kimon C, Hooper, David C, Turbett, Sarah E, Hyle, Emily P
المساهمون: National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Harvard Catalyst Medial Research Investigator Training fellowship
المصدر: Open Forum Infectious Diseases ; volume 8, issue 1 ; ISSN 2328-8957
بيانات النشر: Oxford University Press (OUP)
سنة النشر: 2020
الوصف: Background Concerns about false-negative (FN) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid amplification tests (NAATs) have prompted recommendations for repeat testing if suspicion for coronavirus disease 2019 (COVID-19) infection is moderate to high. However, the frequency of FNs and patient characteristics associated with FNs are poorly understood. Methods We retrospectively reviewed test results from 15 011 adults who underwent ≥1 SARS-CoV-2 NAATs; 2699 had an initial negative NAAT and repeat testing. We defined FNs as ≥1 negative NAATs followed by a positive NAAT within 14 days during the same episode of illness. We stratified subjects with FNs by duration of symptoms before the initial FN test (≤5 days versus >5 days) and examined their clinical, radiologic, and laboratory characteristics. Results Sixty of 2699 subjects (2.2%) had a FN result during the study period. The weekly frequency of FNs among subjects with repeat testing peaked at 4.4%, coinciding with peak NAAT positivity (38%). Most subjects with FNs had symptoms (52 of 60; 87%) and chest radiography (19 of 32; 59%) consistent with COVID-19. Of the FN NAATs, 18 of 60 (30%) were performed early (ie, ≤1 day of symptom onset), and 18 of 60 (30%) were performed late (ie, >7 days after symptom onset) in disease. Among 17 subjects with 2 consecutive FNs on NP NAATs, 9 (53%) provided lower respiratory tract (LRT) specimens for testing, all of which were positive. Conclusions Our findings support repeated NAATs among symptomatic patients, particularly during periods of higher COVID-19 incidence. The LRT testing should be prioritized to increase yield among patients with high clinical suspicion for COVID-19.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1093/ofid/ofaa559
DOI: 10.1093/ofid/ofaa559/34470493/ofaa559.pdf
الاتاحة: http://dx.doi.org/10.1093/ofid/ofaa559
http://academic.oup.com/ofid/advance-article-pdf/doi/10.1093/ofid/ofaa559/34470493/ofaa559.pdf
http://academic.oup.com/ofid/article-pdf/8/1/ofaa559/38547580/ofaa559.pdf
Rights: http://creativecommons.org/licenses/by-nc-nd/4.0/
رقم الانضمام: edsbas.83744E57
قاعدة البيانات: BASE