Delayed RT-PCR Time-To-Positivity in an adult with SARS-CoV-2 Infection

  • Nur Chandra Bunawan Coronavirus Disease 2019 (COVID-19) Task Force, Kramat Jati Regional General Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-6328-1653
  • Md Ikhsan Mokoagow Department of Internal Medicine, Fatmawati General Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-8141-0324
  • Aryan Yohanes Djojo Department of Internal Medicine, Fatmawati General Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-7282-4920
  • Natalia Wistriany Coronavirus Disease 2019 (COVID-19) Task Force, Kramat Jati Regional General Hospital, Jakarta, Indonesia
  • Hardijatmo Muljo Nugroho Coronavirus Disease 2019 (COVID-19) Task Force, Kramat Jati Regional General Hospital, Jakarta, Indonesia
  • Annisa Dian Harlivasari Coronavirus Disease 2019 (COVID-19) Task Force, Kramat Jati Regional General Hospital, Jakarta, Indonesia
  • Setioningsih Diponegoro Coronavirus Disease 2019 (COVID-19) Task Force, Kramat Jati Regional General Hospital, Jakarta, Indonesia
Keywords: RT-PCR, time-to-positivity, SARS-CoV-2, false negative

Abstract

Early diagnosis is among the crucial measures to control the spread of SARS-CoV-2 infection. To date, reverse transcription polymerase chain reaction (RT-PCR) is the gold standard for COVID-19 testing, but various factors can affect its performance leading to false negative results. Hereby we present a patient with a high clinical suspicion for COVID-19 and had multiple negative RT-PCR results over 5 days. A 22-year-old woman presented with fever, dry cough, nausea, myalgia, headache, and mild dyspnea. Eleven days before, she was in close contact with her father who had tested positive for COVID-19. RT-PCR on nasopharyngeal and oropharyngeal swabs were performed on day 8, 9, and 12 of illness which all came back negative even after she started having a worsening dyspnea and showing an increased lung opacity from radiographic findings on day 11 of illness. Interestingly, her rapid antibody test (VivaDiag COVID-19 IgM/IgG rapid test by VivaChek Biotech (HangZhou,China) was positive for anti-SARS-CoV-2 Ig M and Ig G. Due to the worsening condition, she was referred to a tertiary hospital where her RT PCR result was positive on day 13 of illness. After 28 days from her first symptom, she was discharged from the hospital with improved symptoms and chest X-ray. As conclusions, in patients with high suspicion of COVID-19, repeat swab tests are mandatory if previous tests were negative. The diagnosis and treatment plan of COVID-19 should not solely be based on RT-PCR, but also consider the patient’s history, symptoms, laboratory result, and radiographic findings.

Published
2021-07-31
How to Cite
1.
Bunawan NC, Mokoagow MI, Djojo AY, Natalia Wistriany, Nugroho HM, Harlivasari AD, Diponegoro S (2021) Delayed RT-PCR Time-To-Positivity in an adult with SARS-CoV-2 Infection. J Infect Dev Ctries 15:913-917. doi: 10.3855/jidc.14766
Section
Coronavirus Pandemic