Positive Chest CT and Negative RT-PCR Testing in a Case of Suspected COVID-19

Abstract

2019 novel coronavirus disease (COVID-19) is caused by SARS-COV-2 virus, and manifests itself through a clinical spectrum from asymptomatic to severe acute respiratory distress and death. Treatment is supportive, though various lysosomotropic and antiviral agents, like hydroxychloroquine and remdesivir respectively, are being investigated in various trials all over the world [1].

Navigating the Diagnostics of COVID-19

“…In contrast, chest computed tomography (CT) scan findings, though not specific for COVID-19-associated pneumonia, may be more sensitive for diagnosis than chest radiograph, especially where viral testing may be constrained or during a false-negative nasopharyngeal real-time reverse-transcription polymerase chain reaction (RT-PCR) test in mild or severe suspected cases [11,17,20]. Retrospective case studies identified diverse abnormal CT findings, including groundglass opacities most prominent from day 0 to day 4 after symptom onset (usually bilateral and peripheral distribution), which can become very extensive with disease progression and present as multifocal solid consolidative opacities [11,14].…”

“…Unfortunately, a negative PCR test on its own still cannot rule out the possibility of infection. As local authorities would go on to report cases where despite the patients' initial realtime RT-PCR test proving to be negative, they would demonstrate chest CT scans with various degrees of consolidation and ground-glass opacity [20,26]. This could also explain the initial proposals of pneumonia of unknown origins during the early days of the outbreak as those patients' CT scans revealed different levels of thick, abundant opacities alongside negative results of the initial PCR test [1].…”