Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 18;14(2):175.
doi: 10.3390/v14020175.

Distinct Outcomes in COVID-19 Patients with Positive or Negative RT-PCR Test

Maria Clara Saad Menezes  1 , Diego Vinicius Santinelli Pestana  1 , Juliana Carvalho Ferreira  2 , Carlos Roberto Ribeiro de Carvalho  2 , Marcelo Consorti Felix  2 , Izabel Oliva Marcilio  2 , Katia Regina da Silva  2 , Vilson Cobello Junior  2 , Julio Flavio Marchini  2 , Julio Cesar Alencar  2 , Luz Marina Gomez Gomez  1 , Denis Deratani Mauá  3 , Heraldo Possolo Souza  1 , Emergency Usp Covid-Group  1 , Hcfmusp Covid-Study Group  2
Affiliations

Distinct Outcomes in COVID-19 Patients with Positive or Negative RT-PCR Test

Maria Clara Saad Menezes et al. Viruses. .

Abstract

Identification of the SARS-CoV-2 virus by RT-PCR from a nasopharyngeal swab sample is a common test for diagnosing COVID-19. However, some patients present clinical, laboratorial, and radiological evidence of COVID-19 infection with negative RT-PCR result(s). Thus, we assessed whether positive results were associated with intubation and mortality. This study was conducted in a Brazilian tertiary hospital from March to August of 2020. All patients had clinical, laboratory, and radiological diagnosis of COVID-19. They were divided into two groups: positive (+) RT-PCR group, with 2292 participants, and negative (-) RT-PCR group, with 706 participants. Patients with negative RT-PCR testing and an alternative most probable diagnosis were excluded from the study. The RT-PCR(+) group presented increased risk of intensive care unit (ICU) admission, mechanical ventilation, length of hospital stay, and 28-day mortality, when compared to the RT-PCR(-) group. A positive SARS-CoV-2 RT-PCR result was independently associated with intubation and 28 day in-hospital mortality. Accordingly, we concluded that patients with a COVID-19 diagnosis based on clinical data, despite a negative RT-PCR test from nasopharyngeal samples, presented more favorable outcomes than patients with positive RT-PCR test(s).

Keywords: COVID-19; COVID-19 testing; SARS-CoV-2; hospital mortality; intubation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Scheme 1
Scheme 1
(A) Institutional protocol for SARS-CoV-2 RT-PCR collection. (B) Distribution of participants.
Figure 1
Figure 1
The median days of COVID-19 symptoms on hospital admission was: diabetes vs. no diabetes (7 and 7, p = 0.54), cancer vs. no cancer; (4 and 8, p < 0.001), hypertension vs. no hypertension (7 and 7, p = 0.26), asthma vs. no asthma (7 and 7, p = 0.46), chronic kidney disease vs. no chronic kidney disease (6 and 7, p < 0.001), and cardiovascular disease vs. no cardiovascular disease (7 and 7, p < 0.001).
Figure 2
Figure 2
A positive RT-PCR test result was associated with a hazard ratio (HR) of 1.44 (95% confidence interval (CI) 1.26–1.65, p value < 0.005) for intubation.
Figure 3
Figure 3
A positive RT-PCR was associated with a hazard ratio (HR) of 1.09 (95% confidence interval (CI) 0.91–1.31, p = 0.33) for in-hospital mortality.
See this image and copyright information in PMC

References

    1. Brandão Neto R.A., Marchini J.F., Marino L.O., Alencar J.C., Lazar Neto F., Ribeiro S., Salvetti F.V., Rahhal H., Gomez Gomez L.M., Bueno C.G., et al. Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study. PLoS ONE. 2021;16:e0244532. - PMC - PubMed
    1. Goyal P., Choi J.J., Pinheiro L.C., Schenck E.J., Chen R., Jabri A., Satlin M.J., Campion Jr T.R., Nahid M., Ringel J.B., et al. Clinical Characteristics of COVID-19 in New York City. N. Engl. J. Med. 2020;382:2372–2374. doi: 10.1056/NEJMc2010419. - DOI - PMC - PubMed
    1. Wu C., Chen X., Cai Y., Zhou X., Xu S., Huang H., Zhang L., Zhou X., Du C., Zhang Y., et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern. Med. 2020;180:934–943. doi: 10.1001/jamainternmed.2020.0994. - DOI - PMC - PubMed
    1. World Health Organization (WHO) Clinical Management of COVID-19—Interim Guidance. World Health Organization; Geneva, Switzerland: May 27, 2020. [(accessed on 6 January 2022)]. Available online: https://apps.who.int/iris/handle/10665/332196.
    1. Woloshin S., Patel N., Kesselheim A.S. False Negative Tests for SARS-CoV-2 Infection—Challenges and Implications. N. Engl. J. Med. 2020;383:e38. doi: 10.1056/NEJMp2015897. - DOI - PubMed

Publication types

MeSH terms