Predictive factors of COVID-19 in patients with negative RT-qPCR.

Autor:	López de la Iglesia J; Especialista en Medicina Familiar y Comunitaria, Centro de salud Condesa, León, Spain., Fernández-Villa T; Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain. Electronic address: tferv@unileon.es., Rivero A; Dirección de Enfermería, Gerencia de Atención Primaria del Área de Salud de León, Spain., Carvajal A; Departamento de Sanidad Animal, Universidad de León, León, Spain., Bay Simon E; Residente de cuarto año de medicina familiar y comunitaria, Centro de Salud San Andrés del Rabanedo, León, Spain., Martínez Martínez M; Enfermera de la Gerencia de Atención Primaria, León, Spain., Argüello H; Departamento de Sanidad Animal, Universidad de León, León, Spain., Puente H; Departamento de Sanidad Animal, Universidad de León, León, Spain., Fernández Vázquez JP; Gerencia de Atención Primaria de León, León, Spain.
Jazyk:	angličtina
Zdroj:	Semergen [Semergen] 2020 Aug; Vol. 46 Suppl 1, pp. 6-11. Date of Electronic Publication: 2020 Jun 23.
DOI:	10.1016/j.semerg.2020.06.010
Abstrakt:	Objective: To evaluate the factors associated with false negatives in RT-qPCR in patients with mild-moderate symptoms of COVID-19. Materials and Methods: This was a cross-sectional study that used a random sample of non-hospitalized patients from the primary care management division of the Healthcare Area of Leon (58 RT-qPCR-positive cases and 52 RT-qPCR-negative cases). Information regarding symptoms was collected and all patients were simultaneously tested using two rapid diagnostic tests - RDTs (Combined - cRDT and Differentiated - dRDT). The association between symptoms and SARS-CoV-2 infection was evaluated by non-conditional logistic regression, with estimation of Odds Ratio. Results: A total of 110 subjects were studied, 52% of whom were women (mean age: 48.2±11.0 years). There were 42.3% of negative RT-qPCRs that were positive in some RDTs. Fever over 38°C (present in 35.5% of cases) and anosmia (present in 41.8%) were the symptoms most associated with SARS-CoV-2 infection, a relationship that remained statistically significant in patients with negative RT-qPCR and some positive RDT (aOR=6.64; 95%CI=1.33-33.13 and aOR=19.38; 95% CI=3.69-101.89, respectively). Conclusions: RT-qPCR is the technique of choice in the diagnosis of SARS-CoV-2 infection, but it is not exempt from false negatives. Our results show that patients who present mild or moderate symptoms with negative RT-qPCR, but with fever and/or anosmia, should be considered as suspicious cases and should be evaluated with other diagnostic methods. (Copyright © 2020 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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