Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19

Abstract

In this study, we collected a total of 610 hospitalized patients from Wuhan between February 2, 2020, and February 17, 2020. We reported a potentially high false negative rate of real-time reverse-transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 in the 610 hospitalized patients clinically diagnosed with COVID-19 during the 2019 outbreak. We also found that the RT-PCR results from several tests at different points were variable from the same patients during the course of diagnosis and treatment of these patients. Our results indicate that in addition to the emphasis on RT-PCR testing, clinical indicators such as computed tomography images should also be used not only for diagnosis and treatment but also for isolation, recovery/discharge, and transferring for hospitalized patients clinically diagnosed with COVID-19 during the current epidemic. These results suggested the urgent needs for the standard of procedures of sampling from different anatomic sites, sample transportation, optimization of RT-PCR, serology diagnosis/screening for SARS-CoV-2 infection, and distinct diagnosis from other respiratory diseases such as fluenza infections as well.

Keywords: COVID-19; RT-PCR.

Figure 1

Distribution of real‐time reverse‐transcriptase polymerase chain reaction (RT‐PCR) test results of SARS‐CoV‐2. Distribution of the RT‐PCR results of the initial test for all patients (A). Distribution of the RT‐PCR results of the second test for patients with initial negative results (B). RT‐PCR test results of SARS‐CoV‐2 of 12 patients with initial non‐positive RT‐PCR result (C). RT‐PCR test results of SARS‐CoV‐2 of 17 patients with unstable RT‐PCR test result among different time points (D)

Figure 2

The networks of real‐time reverse‐transcriptase polymerase chain reaction (RT‐PCR) result transformations about frequencies and average intervals. Frequencies of RT‐PCR results transformations (A). Average intervals of RT‐PCR results transformations (B)