False negative of RT‐PCR and prolonged nucleic acid conversion in COVID‐19: Rather than recurrence

Xiao, Ai Tang; Tong, Yi Xin; Zhang, Sheng

doi:10.1002/jmv.25855

Cited by 483 publications

(538 citation statements)

References 7 publications

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“…Some studies reported that potentially high false-negative rate of real-time reverse-transcriptase RT-PCR testing for SARS-CoV-2 and patients experienced a "turn positive" of nucleic acid detection by RT-PCR test for SARS-CoV-2 after two consecutive negative results. [19,30] For suspected cases, the nasopharyngeal swab should be taken, but waiting for the test results should not delay treatment. Serology tests for detecting the antibody can also be useful for COVID-19 diagnosis if available.…”

Section: Appropriate Laboratory Tests For Covid 19 Should Be Chosenmentioning

confidence: 99%

Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic

Gök

Eryılmaz

Özmen

et al. 2020

Ulus Travma Acil Cerrahi Derg

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COVID-19 is a new disease, based on currently available limited information, older adults and people of any age who have severe underlying medical conditions may be at higher risk for severe illness from COVID-19. People of all age groups are also at risk. Healthcare providers have always been the professionals most exposed to the risk of contracting to any kind of infection due to the nature of their profession. Elective interventions have been postponed to give care of patients with COVID-19. However, some interventions cannot be delayed, such as trauma surgery, acute abdomen, and emergency endoscopies. To maintain the sustainability of the healthcare system, the protection of healthcare providers should be the top priority. On the other hand, patients, who need emergency healthcare, should also be provided with appropriate treatment. Healthcare professionals should choose a treatment method appropriately in the circumstances to protect themselves and their patients as much as possible. This paper aims to summarize how a surgeon may act appropriately when an intervention is inevitable during the COVID-19 pandemic.

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Section: Appropriate Laboratory Tests For Covid 19 Should Be Chosenmentioning

confidence: 99%

Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic

Gök

Eryılmaz

Özmen

et al. 2020

Ulus Travma Acil Cerrahi Derg

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“…20 This study demonstrated a rate of re-detectable positive nucleic acid as high as 52.7% (39/74) despite strict adherence to domestic guidelines on discharge criteria, which may be attributed to the fact that SARS-CoV-2 mainly resides in the lower respiratory system. 21,22 In addition, possible deviation in specimen collection may lead to false negativity of nucleic testing and consequently inappropriate discharge decisions, 23,24 resulting in recurrence and even deterioration of the disease. The 20 patients with re-detectable positive nucleic acid displayed decline in lymphocyte subsets on the second admission, which was similar to the changes of initial infection.…”

Section: The Association Of Sars-cov-2 Antibodies With Re-detectablementioning

confidence: 99%

The production and clinical implications of SARS-CoV-2 antibodies

2020

Preprint

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Funding 1. Chongqing Education Board "new coronavirus infection and prevention" emergency scientific research project (KYYJ202006).2. Chongqing Science and Technology Bureau "new crown pneumonia epidemic emergency science and technology special" the fourth batch of projects. Famous teacher project of Chongqing talent planAll rights reserved. No reuse allowed without permission. AbstractBackground: Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), a novel betacoronavirus, has caused an outburst of pneumonia cases in Wuhan, China. We report the production of specific IgM and IgG antibodies after the infection of SARS-CoV-2 and its implication for the diagnosis, pathology and the course of the disease as well as the recurrence of positive nucleic acid tests after discharge.Methods: Test results for SARS-CoV-2 IgM and IgG antibodies of 221 confirmed COVID-19 patients were retrospectively examined, and their clinical data were collected and analyzed based on various subgroups. SARS-CoV-2 IgM and IgG antibodies were determined with the chemiluminescence method. Findings: The concentration (S/CO) of SARS-CoV-2 IgM and IgG antibodies peaked on day 19-21 after symptom onset, with a median of 17.38 (IQR 4.39-36.4) for IgM and 5.59 (IQR 0.73-13.65) for IgG.Detection rates reached highest on day 16-18 and day 19-21 for IgM and IgG, which were 73.6% and 98.6%, respectively, with significantly higher concentration of IgG in critically ill patients than in those with mild to moderate disease (P=0.027). The concentration of the antibodies on day 16-21 is not correlated with the course or outcome of the disease (Spearman r < 0.20, P > 0.05). Nasopharyngeal swabs revealed positive SARS-CoV-2 RNA in up to 52.7% of recovered patients after discharge, whose IgG proved to be significantly lower than that of those with negative RNA results (P = 0.009). IgG and IgM were tested twice within 14 days after discharge with a 7-day interval, and the second testing of these antibodies displayed a decrease in concentration of 21.2% (IQR, 11.2%，34.48%) for IgG and 23.05% (IQR, -27.96%，46.13%) for IgM, without statistical significance between the patients with redetectable positive RNA results and those with negative RNA results after discharge. However, those with positive results experienced a count decrease in lymphocyte subsets.Interpretation: The concentration of SARS-CoV-2 IgM and IgG antibodies peaked on day 19-21 after symptom onset, and antibody testing on day 16-21 is associated with increased detection rates, but the antibody concentration does not affect the course and outcome of the infection. Recovering patients with re-detectable positive SARS-CoV-2 RNA displayed lower concentration of IgG, but the downward trend of IgG during recovery indicated its limited duration of protection, and the protective effect of IgG remains to be investigated.Funding: Chongqing Education Board, Chongqing Science and Technology Bureau, Famous teacher project of Chongqing talent plan All rights reserved. No reuse allowed without permission.

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“…8 SARS-CoV-2 RNA has also been detected in throat or nasopharyngeal swabs more than 20 days after negative test results. 9 In another report among 18 patients, viral burdens (as determined by PCR cycle threshold) were generally lower than, and had declined substantially from, values during peak of illness. 10 At the time of postrecovery positive test results, the patients described in these reports had few, if any, symptoms, and when radiographically examined, they demonstrated stable or improving pneumonia.…”

mentioning

confidence: 93%

COVID-19 and Postinfection Immunity

Kirkcaldy

King

Brooks

2020

JAMA

219

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False negative of RT‐PCR and prolonged nucleic acid conversion in COVID‐19: Rather than recurrence

Abstract: All procedures followed in this study were in accordance with the 1964 Helsinki Declaration and later versions. Oral consent was obtained from patients involved before enrollment when data were collected retrospectively.

Cited by 483 publications

References 7 publications

Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic

Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic

The production and clinical implications of SARS-CoV-2 antibodies

COVID-19 and Postinfection Immunity

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