Results of an early second PCR test performed on SARS-CoV-2 positive patients may support risk assessment for severe COVID-19

Barak Mizrahi,Yoav Yehezkelli,Pinchas Akiva,Sharon Hermoni Alon,Gabriel Chodick,Eitan Rubin,Maytal Bivas-Benita,Yoav Kessler,Nir Kalkstein,Chen Yanover

doi:10.1038/s41598-021-99671-5

Abstract

Identifying patients at increased risk for severe COVID-19 is of high priority during the pandemic as it could affect clinical management and shape public health guidelines. In this study we assessed whether a second PCR test conducted 2–7 days after a SARS-CoV-2 positive test could identify patients at risk for severe illness. Analysis of a nationwide electronic health records data of 1683 SARS-CoV-2 positive individuals indicated that a second negative PCR test result was associated with lower risk for severe illness compared to a positive result. This association was seen across different age groups and clinical settings. More importantly, it was not limited to recovering patients but also observed in patients who still had evidence of COVID-19 as determined by a subsequent positive PCR test. Our study suggests that an early second PCR test may be used as a supportive risk-assessment tool to improve disease management and patient care.

Highlights

The COVID-19 pandemic is continuing to spread, surpassing 222 M confirmed cases and 4.5 M deaths globally as of September 20211
Another subpopulation we explored was of 3,135 adults who had additional multiple polymerase chain reaction (PCR) tests between their first and last documented positive SARS-CoV-2 test
This study explored the clinical implications of a second NP PCR testing in SARS-CoV-2 infected individuals utilizing electronic health records (EHR) data from the second largest Health Maintenance Organization (HMO) in Israel

Summary

Introduction

The COVID-19 pandemic is continuing to spread, surpassing 222 M confirmed cases and 4.5 M deaths globally as of September 20211. Survival rates have gradually improved by the development of successful treatment protocols for moderate and severe patients, the disease continues to claim lives and containment is proven difficult[2,3,4,5,6]. Strategies for detection and containment of COVID-19 have evolved and that testing has become more available it is performed both in communitybased sites and in hospitals. Multiple testing following exposure and diagnosis of COVID-19 patients has been used to evaluate infectiousness and assure resolution of infection, especially considering the known silent spread by infected individuals that are asymptomatic[7,8,9,10,11,12]

Methods

Results

Conclusion