Patients with Initial Negative RT-PCR and Typical Imaging of COVID-19: Clinical Implications.
Fiche publication
Date publication
septembre 2020
Journal
Journal of clinical medicine
Auteurs
Membres identifiés du Cancéropôle Est :
Pr OHANA Mickaël
Tous les auteurs :
Baicry F, Le Borgne P, Fabacher T, Behr M, Lemaitre EL, Gayol PA, Harscoat S, Issur N, Garnier-Kepka S, Ohana M, Bilbault P, Oberlin M
Lien Pubmed
Résumé
The sensitivity of reverse transcriptase polymerase chain reaction (RT-PCR) has been questioned due to negative results in some patients who were strongly suspected of having coronavirus disease 2019 (COVID-19). The aim of our study was to analyze the prognosis of infected patients with initial negative RT-PCR in the emergency department (ED) during the COVID-19 outbreak. This study included two cohorts of adult inpatients admitted into the ED. All patients who were suspected to be infected with SARS-CoV-2 and who underwent a typical chest CT imaging were included. Thus, we studied two distinct cohorts: patients with positive RT-PCR (PCR+) and those with negative initial RT-PCR (PCR-). The data were analyzed using Bayesian methods. We included 66 patients in the PCR- group and 198 in the PCR+ group. The baseline characteristics did not differ except in terms of a proportion of lower chronic respiratory disease in the PCR- group. We noted a less severe clinical presentation in the PCR- group (lower respiratory rate, lower oxygen need and mechanical ventilation requirement). Hospital mortality (9.1% vs. 9.6%) did not differ between the two groups. Despite an initially less serious clinical presentation, the mortality of patients infected by SARS-CoV-2 with a negative RT-PCR did not differ from those with positive RT-PCR.
Mots clés
Bayesian analysis, COVID-19, clinical management, reverse transcriptase polymerase chain reaction
Référence
J Clin Med. 2020 Sep 18;9(9):