Abstract
BackgroundThe novel coronavirus disease 2019 (COVID-19) was emergency turned into global public health after the first patients were detected in Wuhan, China, in December 2019. The disease rapidly expanded and led to an epidemic throughout China, followed by the rising number of cases worldwide. Given the high prevalence of COVID-19, rapid and accurate diagnostic methods are immediately needed to identify, isolate and treat the patients as soon as possible, decreasing mortality rates and the risk of public contamination by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).MethodsThis case-control study was conducted in two hospitals in Alborz Province in Iran. All recruited cases in this study were symptomatic adults hospitalized as COVID-19 patients with compatible Computed tomographic (CT) scan findings and available rRT-PCR results. The patients were recruited in this study. The patients were categorized into positive and negative rRT-PCR groups and evaluated for symptoms, initial vital signs, comorbidity, clinical and laboratory findings. Finally, the results were assessed by SPSS software.ResultsBetween March 5 to April 5, 2020, 164 symptomatic COVID-19 patients were studied. In total, there were 111 rRT-PCR positive (67.6%) and 53 rRT-PCR negative patients (32.4%). In terms of statistics, the frequency of symptoms revealed no difference, except for cough (P.V:0.008), dizziness (PV: 0.048), and weakness (P.V:0.022). Among initial vital signs, PR (P.V:0.041) and O2 Saturation (PV: 0.014) were statistically different between the two groups. Evaluation of comorbidities revealed no difference except for hyperlipidemia (P.V:0.024). In the comparison of laboratory findings, only WBC count (PV: 0.001), lymphocyte count (PV: 0.001), and Hb (P.V:0.008) were statistically different between the two groups.ConclusionIn case of the negative rRT-PCR result, it is necessary to take a logical approach, and we recommended that the physician decides according to clinical manifestations, laboratory findings, and positive CT results.
Highlights
The novel coronavirus disease 2019 (COVID-19) was emergency turned into global public health after the first patients were detected in Wuhan, China, in December 2019
The result of reverse transcriptase-polymerase chain reaction (rRT-PCR) for COVID-19 was positive in 111 patients (67.3%) and 53 patients (32.1%) showed negative rRT-PCR results
We found 68.1% rRT-PCR positive results, a percentage that may be due to the same test conditions, including the operator performing the test, sampling method, diagnostic kit, etc. for all samples, we detected a slight difference between positive and negative rRT-PCR patients in terms of clinical and laboratory findings, initial vital signs and comorbidity
Summary
The novel coronavirus disease 2019 (COVID-19) was emergency turned into global public health after the first patients were detected in Wuhan, China, in December 2019. Given the high prevalence of COVID-19, rapid and accurate diagnostic methods are immediately needed to identify, isolate and treat the patients as soon as possible, decreasing mortality rates and the risk of public contamination by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). Severe pneumonia and acute respiratory distress syndrome (ARDS) have been reported in 14% of cases with an overall mortality rate of 2% [5] These figures are rising concomitant with pandemic expansion depending on the country involved [6]. Regarding the high rate of infection of COVID-19, Accurate and rapid diagnostic methods are urgently required for detection, isolation, and treatment of patients as soon as possible, which can decrease the community contamination and mortality rate [9]. The sensitivity of the rRTPCR kit can give rise to false-negative results [9]
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