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RT-PCR negative COVID-19.
Parmar, Heta; Montovano, Margaret; Banada, Padmapriya; Pentakota, Sri Ram; Shiau, Stephanie; Ma, Zhongjie; Saibire, Kaheerman; Chopoorian, Abby; O'Shaughnessy, Michael; Hirsch, Mitchell; Jain, Priyanshi; Demirdjian, Gaiane; Karagueuzian, Magali; Robin, Thomas; Salvati, Michael; Patel, Bhavana; Alland, David; Xie, Yingda L.
  • Parmar H; The Public Health Research Institute and the Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Montovano M; School of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Banada P; The Public Health Research Institute and the Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Pentakota SR; The Public Health Research Institute and the Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Shiau S; Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
  • Ma Z; Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
  • Saibire K; The Public Health Research Institute and the Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Chopoorian A; The Public Health Research Institute and the Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • O'Shaughnessy M; School of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Hirsch M; School of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Jain P; School of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Demirdjian G; School of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Karagueuzian M; Beckman Coulter Inc., Brea, CA, USA.
  • Robin T; Beckman Coulter Inc., Brea, CA, USA.
  • Salvati M; Beckman Coulter Inc., Brea, CA, USA.
  • Patel B; Beckman Coulter Inc., Brea, CA, USA.
  • Alland D; University Hospital, Newark, NJ, USA.
  • Xie YL; The Public Health Research Institute and the Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA. allandda@njms.rutgers.edu.
BMC Infect Dis ; 22(1): 149, 2022 Feb 13.
Article in English | MEDLINE | ID: covidwho-1745491
ABSTRACT

BACKGROUND:

COVID-19 is a multi-system infection with emerging evidence-based antiviral and anti-inflammatory therapies to improve disease prognosis. However, a subset of patients with COVID-19 signs and symptoms have repeatedly negative RT-PCR tests, leading to treatment hesitancy. We used comparative serology early in the COVID-19 pandemic when background seroprevalence was low to estimate the likelihood of COVID-19 infection among RT-PCR negative patients with clinical signs and/or symptoms compatible with COVID-19.

METHODS:

Between April and October 2020, we conducted serologic testing of patients with (i) signs and symptoms of COVID-19 who were repeatedly negative by RT-PCR ('Probables'; N = 20), (ii) signs and symptoms of COVID-19 but with a potential alternative diagnosis ('Suspects'; N = 15), (iii) no signs and symptoms of COVID-19 ('Non-suspects'; N = 43), (iv) RT-PCR confirmed COVID-19 patients (N = 40), and (v) pre-pandemic samples (N = 55).

RESULTS:

Probables had similar seropositivity and levels of IgG and IgM antibodies as propensity-score matched RT-PCR confirmed COVID-19 patients (60.0% vs 80.0% for IgG, p-value = 0.13; 50.0% vs 72.5% for IgM, p-value = 0.10), but multi-fold higher seropositivity rates than Suspects and matched Non-suspects (60.0% vs 13.3% and 11.6% for IgG; 50.0% vs 0% and 4.7% for IgM respectively; p-values < 0.01). However, Probables were half as likely to receive COVID-19 treatment than the RT-PCR confirmed COVID-19 patients with similar disease severity.

CONCLUSIONS:

Findings from this study indicate a high likelihood of acute COVID-19 among RT-PCR negative with typical signs/symptoms, but a common omission of COVID-19 therapies among these patients. Clinically diagnosed COVID-19, independent of RT-PCR positivity, thus has a potential vital role in guiding treatment decisions.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: S12879-022-07095-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: S12879-022-07095-x