Evidence map›Paper›PMID 32566476›Full record

ArticleRespiratory medicine case reports2020

Detection of SARS-CoV-2 by bronchoscopy after negative nasopharyngeal testing: Stay vigilant for COVID-19.

Kathleen J Ramos, Siddhartha G Kapnadak, Bridget F Collins, Paul S Pottinger, Richard Wall, James A Mays, Garrett A Perchetti, Keith R Jerome, Sandeep Khot, Ajit P Limaye and 2 more

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Respiratory medicine case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
0.7field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.

  1. Pooled it
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  15. Analytical insights of COVID-19 pandemic.Trends in analytical chemistry : TRAC · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Kathleen J RamosDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington Medical Center, Seattle, WA, USA.
Siddhartha G KapnadakDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington Medical Center, Seattle, WA, USA.
Bridget F CollinsDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington Medical Center, Seattle, WA, USA.
Paul S PottingerDivision of Allergy & Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Richard WallPulmonary, Critical Care, and Sleep Disorders Medicine, University of Washington Valley Medical Center, Renton, WA, USA.
James A MaysDepartment of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Garrett A PerchettiDepartment of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Keith R JeromeDepartment of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Sandeep KhotDepartment of Neurology, University of Washington Medical Center, Seattle, WA, USA.
Ajit P LimayeDivision of Allergy & Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Patrick C MathiasDepartment of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Alexander GreningerDepartment of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, USA.
University of Washington · USUniversity of Washington Medical Center · USFred Hutch Cancer Center · USValley Medical Center · US

Funding

Predicting survival and planning for lung transplantation in severe cystic fibrosisK23HL138154 · NHLBI · UNIVERSITY OF WASHINGTON · PI RAMOS, KATHLEEN JESSICA · 2017 to 2021
$947k
NHLBI NIH HHS K23 HL138154
6 · The paper itself

Abstract

purposeReal-time polymerase chain reaction (RT-PCR) detection of severe acute respiratory syndrome coronavirus (SARS-CoV-2) is required for diagnosis of coronavirus disease 2019 (COVID-19). Sensitivity of RT-PCR nasopharyngeal (NP) testing is presumed to be high, but there is no gold standard against which this has been determined. The objective was to determine whether lower respiratory tract infection (LRTI), detected in bronchoalveolar lavage fluid (BALF), occurs in the absence of upper respiratory tract infection with clinical testing of both specimen types.

methodsBetween March 26, 2020 and April 17, 2020 at the University of Washington Medical Center all patients with BALF specimens clinically tested for SARS-CoV-2 were identified. We assessed the proportion of patients with positive RT-PCR for SARS-CoV-2 in BALF after negative NP testing. We describe 3 cases with positive testing in BALF.

resultsAmong 16 patients with BALF samples, 3 cases (19%) had SARS-CoV-2 detected in BALF. In Case 1, negative NP testing occurred early in the infection and respiratory symptoms may have been missed due to neurologic injury. In Case 2, outpatient diagnosis was aspiration pneumonia, but clinical suspicion remained high for COVID-19 at hospitalization based on epidemiological and clinical features. All 3 cases involved older adults (age >65 years), one of whom was immunosuppressed in the setting of lung transplantation (Case 3).

conclusionsThese data demonstrate that SARS-CoV-2 LRTI occurs in the presence of negative NP testing. NP testing may underestimate the prevalence of COVID-19 and has implications for spread of SARS-CoV2 in the community and healthcare setting.

Identifiers

PMID32566476
PMCPMC7298516
OpenAlexW3034631031

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.