ArticleBMJ open2021
False-negative RT-PCR for COVID-19 and a diagnostic risk score: a retrospective cohort study among patients admitted to hospital.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Evaluation of Diagnostic Strategies for Identifying SARS-CoV-2 Infection in Clinical Practice: a Systematic Review and Compliance with the Standards for Reporting Diagnostic Accuracy Studies Guideline (STARD).Microbiology spectrum · 2022Pooled it
- Clinical prediction models for diagnosis of COVID-19 among adult patients: a validation and agreement study.BMC infectious diseases · 2022Pooled it
- Epidemiological contemplation for a currently pragmatic COVID-19 health passport: a perspective.Frontiers in public health · 2024Review
- The Diagnostic Performance of Various Clinical Specimens for the Detection of COVID-19: A Meta-Analysis of RT-PCR Studies.Diagnostics (Basel, Switzerland) · 2023Review
- Long and Short-term Metformin Consumption as a Potential Therapy to Prevent Complications of COVID-19.Advanced pharmaceutical bulletin · 2023Article
- Article
- Correlation of serum SARS-CoV-2 IgM and IgG serology and clinical outcomes in COVID-19 patients: Experience from a tertiary care centre.World journal of biological chemistry · 2023Article
- Multi-Attention Segmentation Networks Combined with the Sobel Operator for Medical Images.Sensors (Basel, Switzerland) · 2023Article
- Comparison between the accuracy of chest computerized tomography vs. reverse transcriptase polymerase chain reaction in a tertiary care center in Lebanon; along with their correlation to mortality, morbidity and symptoms in COVID-19 patients.Human gene (Amsterdam, Netherlands) · 2023Article
- Diagnostic accuracy of the Abbott ID NOW SARS-CoV-2 rapid test for the triage of acute medical admissions.The Journal of hospital infection · 2022Article
- Lateral flow-based nucleic acid detection of SARS-CoV-2 using enzymatic incorporation of biotin-labeled dUTP for POCT use.Analytical and bioanalytical chemistry · 2022Article
- The broad spectrum of COVID-like patients initially negative at RT-PCR testing: a cohort study.BMC public health · 2022Article
- False-Positive Results of SARS-CoV-2 RT-PCR in Oropharyngeal Swabs From Vaccinators.Frontiers in medicine · 2022Article
- Case Report: Left atrial myxoma with confirmed Delta variant COVID-19 infection, "to treat or withhold".F1000Research · 2022Article
- Article
- A systematic review of prediction models to diagnose COVID-19 in adults admitted to healthcare centers.Archives of public health = Archives belges de sante publique · 2021Review
- Comparison between RT-qPCR for SARS-CoV-2 and expanded triage in sputum of symptomatic and asymptomatic COVID-19 subjects in Ecuador.BMC infectious diseases · 2021Article
- Auditing the efficacy of prophylactic measures against Covid-19 amongst Healthcare workers in India.The Journal of infection · 2021Article
- Transcriptional Profiling and Machine Learning Unveil a Concordant Biosignature of Type I Interferon-Inducible Host Response Across Nasal Swab and Pulmonary Tissue for COVID-19 Diagnosis.Frontiers in immunology · 2021Article
- RT- PCR testing of upper respiratory tract samples for diagnosis of SARS-CoV-2: Between justification and overestimation, a multi-center international study.Travel medicine and infectious diseaseArticle
Corrections and comments
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Authors and funding
17 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe the characteristics and outcomes of patients with a clinical diagnosis of COVID-19 and false-negative SARS-CoV-2 reverse transcription-PCR (RT-PCR), and develop and internally validate a diagnostic risk score to predict risk of COVID-19 (including RT-PCR-negative COVID-19) among medical admissions.
designRetrospective cohort study.
settingTwo hospitals within an acute NHS Trust in London, UK.
participantsAll patients admitted to medical wards between 2 March and 3 May 2020. OUTCOMES: Main outcomes were diagnosis of COVID-19, SARS-CoV-2 RT-PCR results, sensitivity of SARS-CoV-2 RT-PCR and mortality during hospital admission. For the diagnostic risk score, we report discrimination, calibration and diagnostic accuracy of the model and simplified risk score and internal validation.
results4008 patients were admitted between 2 March and 3 May 2020. 1792 patients (44.8%) were diagnosed with COVID-19, of whom 1391 were SARS-CoV-2 RT-PCR positive and 283 had only negative RT-PCRs. Compared with a clinical reference standard, sensitivity of RT-PCR in hospital patients was 83.1% (95% CI 81.2%-84.8%). Broadly, patients with false-negative RT-PCR COVID-19 and those confirmed by positive PCR had similar demographic and clinical characteristics but lower risk of intensive care unit admission and lower in-hospital mortality (adjusted OR 0.41, 95% CI 0.27-0.61). A simple diagnostic risk score comprising of age, sex, ethnicity, cough, fever or shortness of breath, National Early Warning Score 2, C reactive protein and chest radiograph appearance had moderate discrimination (area under the receiver-operator curve 0.83, 95% CI 0.82 to 0.85), good calibration and was internally validated.
conclusionRT-PCR-negative COVID-19 is common and is associated with lower mortality despite similar presentation. Diagnostic risk scores could potentially help triage patients requiring admission but need external validation.
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