Likelihood of acute COVID-19 in RT-PCR negative patients

Editor's Note

This study by researchers at Rutgers New Jersey Medical School finds that treatment for COVID-19 should be based on clinical judgment and not just testing.

Between April and October 2020, the researchers looked at four groups:

• 40 patients who were RT-PCR confirmed positive
• 20 patients who repeatedly tested negative but had symptoms of COVID-19 in chest imaging and no alternative diagnosis (Probables)
• 15 who repeatedly tested negative and had COVID-19 symptoms or chest imaging findings with a potential alternative diagnosis (Suspects)
• 43 who tested negative and had no symptoms of COVID-19 (Nonsuspects).

The researchers found that Probables had a similar antibody profile as those who were RT-PCR confirmed COVID-19 patients, and Suspects had a similar antibody profile as Nonsuspects.

They also found that only 43% of the severely-ill Probables received COVID-19 treatment compared to 79% of severely-ill RT-PCR confirmed positive patients.

These findings emphasize the critical role that clinical diagnosis has in determining whether to treat a COVID-19 patient and that clinicians should not rely solely on RT-PCR tests, the researchers say.