Repetition of microbiological tests in suspect of SARS-CoV-2 infection: utility of a score based on clinical probability

The diagnosis of SARS-CoV-2 infection presents some limitations. RT-PCR in nasopharyngeal swabs is considered the gold standard for the diagnosis, although it can have false negative results. We aimed to analyze the accuracy of repeating nasopharyngeal swabs based on different clinical probabilities...

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Bibliographic Details
Published in:Revista española de quimioterapia 2020-12, Vol.33 (6), p.410-414
Main Authors: Pardo Lledias, J, Ayarza, L, González-García, P, Salmón González, Z, Calvo Montes, J, Gozalo Marguello, M, Hernández Hernández, J L, Olmos Martínez, J M
Format: Article
Language:spa ; eng
Subjects:
Aged
Antibodies, Viral - analysis
Area Under Curve
Chi-Square Distribution
COVID-19 - diagnosis
COVID-19 Nucleic Acid Testing - methods
COVID-19 Nucleic Acid Testing - statistics & numerical data
COVID-19 Serological Testing - methods
COVID-19 Serological Testing - statistics & numerical data
COVID-19 Testing - methods
COVID-19 Testing - statistics & numerical data
Female
Genes, Viral
Humans
Male
Nasopharynx - virology
Probability
Reproducibility of Results
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction - methods
Reverse Transcriptase Polymerase Chain Reaction - statistics & numerical data
ROC Curve
SARS-CoV-2 - genetics
SARS-CoV-2 - immunology
SARS-CoV-2 - isolation & purification
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Summary:The diagnosis of SARS-CoV-2 infection presents some limitations. RT-PCR in nasopharyngeal swabs is considered the gold standard for the diagnosis, although it can have false negative results. We aimed to analyze the accuracy of repeating nasopharyngeal swabs based on different clinical probabilities. Retrospective observational study of the first patients admitted to a two COVID Internal Medicine wards at the University Hospital Marqués de Valdecilla, Santander, from March to April 2020. RT-PCR targering E, N, RdRP and ORFab1 genes and antibody tests detecting IgG. A total of 145 hospitalized patients with suspected SARS-Cov2 infection were admitted and in 98 (67.5%) diagnosis was confirmed. The independent predictive variables for SARS-CoV-2 infection were: epidemiological contact, clinical presentation as pneumonia, absence of pneumonia in the last year, onset of symptoms > 7 days, two or more of the following symptoms -dyspnea, cough or fever- and serum lactate dehydrogenase levels >350 U/L (p
ISSN:0214-3429
1988-9518
DOI:10.37201/req/080.2020