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

  1. J. López de la Iglesia 1
  2. T. Fernández-Villa 2
  3. A. Rivero 3
  4. A. Carvajal 4
  5. E. Bay Simon 5
  6. M. Martínez Martínez 6
  7. H. Argüello 4
  8. H. Puente 4
  9. J.P. Fernández Vázquez 7
  1. 1 Centro de salud Condesa, León, Spain
  2. 2 Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
  3. 3 Gerencia de Atención Primaria del Área de Salud de León, Spain
  4. 4 Departamento de Sanidad Animal, Universidad de León, León, Spain
  5. 5 Centro de Salud San Andrés del Rabanedo, León, Spain
  6. 6 Gerencia de Atención Primaria, León, Spain
  7. 7 Gerencia de Atención Primaria de León, León, Spain
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Journal:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Year of publication: 2020

Issue Title: COVID19 en Atención Primaria

Issue: 1

Pages: 6-11

Type: Article

DOI: 10.1016/J.SEMERG.2020.06.010 DIALNET GOOGLE SCHOLAR

More publications in: Semergen: revista española de medicina de familia

Abstract

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.

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The authors would like to thank all patients for their participation in this study who have voluntarily agreed to collaborate in the evaluation of diagnostic techniques against COVID-19. Thank you to the primary care management division of the Healthcare Area of Leon and the University of Leon also, because their collaboration has been crucial in developing this study.

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