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Updated: Dec 3, 2025
Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
What are we missing? Three cases of severe COVID-19 pneumonia with negative testing
Aisha Siddiqui1, Sukhdev Singh1, Zohaib Khan1
1College of Medicine, American University of Antigua, New York, NY, USA.
Abstract:
The COVID-19 pandemic has drastically affected health care systems globally. Reverse transcriptase-polymerase chain reaction is currently the preferred method of detecting COVID-19; however, sensitivity of this test remains questionable. Incidental transmission and potential harm to infected individuals are some consequences of the failure to identify high-risk patients. We report three cases of symptomatic patients that required intensive care management with labs and imaging consistent with COVID-19 with initial false-negative reverse transcriptase-polymerase chain reaction testing. Improper sampling, viral load, and manufacturer variances of tests all contribute to reduced sensitivity. A clinical diagnosis should supplant such cases.
Insights
Initial reverse transcriptase-polymerase chain reaction tests for COVID-19 can be falsely negative, potentially leading to patient harm. Clinical judgment is crucial when test results conflict with a patient's condition.
Area of Science:
- Medical Diagnostics
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic necessitated widespread diagnostic testing.
- Reverse transcriptase-polymerase chain reaction (RT-PCR) became the gold standard for SARS-CoV-2 detection.
- Concerns regarding the sensitivity of RT-PCR testing have been raised globally.
Observation:
- Three cases of critically ill patients with symptoms and imaging consistent with COVID-19 presented with initial false-negative RT-PCR results.
- These patients required intensive care unit management.
- The discrepancy between clinical presentation and initial diagnostic testing highlighted potential limitations.
Findings:
- Factors such as improper sample collection, low viral load, and variations in test kits can reduce RT-PCR sensitivity.
- False-negative results can delay appropriate patient management and increase transmission risk.
- The study underscores the variability and potential unreliability of RT-PCR in certain clinical scenarios.
Implications:
- Clinical assessment should be prioritized when RT-PCR results are inconsistent with a patient's presentation.
- Relying solely on RT-PCR may lead to underdiagnosis and inadequate care for COVID-19 patients.
- Further research into improving diagnostic test accuracy and understanding limitations is warranted.
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