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Updated: Jun 25, 2025

Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
"Non-COVID-19" Coronavirus Diseases Not to be Misdiagnosed as COVID-19
Kam Lun Hon1, Alexander K C Leung2, Paul K S Chan3
1Department of Pediatrics, CUHKMC, The Chinese University of Hong Kong, Hong Kong, China.
Background:
The COVID-19 global pandemic was caused by a novel coronavirus (SARS-CoV-2), which then became an endemic infection. COVID refers to the World Health Organization's coined acronym for coronavirus disease.
Case Presentation:
We have, herein, reported three cases of COVIDs that could have been misdiagnosed as COVID-19. All of these families reported previous COVID-19 infection based on selfadministered Rapid Antigen Testing (RAT) and completed a period of home isolation. In these 3 cases, one child had an RSV-associated asthma attack, one had norovirus gastritis, and another had an infection with Campylobacter and E. coli. NL63, OC43, and 229E, respectively, were found by PCR in these patients.
Discussion:
Seven human coronaviruses cause human infectious diseases. Confusion and issues associated with coronavirus disease diagnosis by Polymerase Chain Reaction (PCR) testing and Rapid Antigen Test (RAT) may arise. Some RATs are Antigen Fluorescent Immunoassays (FIA) that target monoclonal antibodies for the detection of viral nucleocapsid protein. Others target the non-nucleocapsid proteins. False positivity is possible. False negativity is also possible if the specimen's antigen level is below the test's detection limit. RAT results usually remain positive for 6 to 7 days, but they may stay positive as long as 2 weeks. Stigmatization with the COVID-19 diagnosis may occur. The PCR test is a highly sensitive 'gold standard' for the detection of COVID-19, but it can also detect non-infectious individuals' fragmented non-infectious viral nucleic acids, and could be positive for a long period. An individual may be tested positive for a few weeks to months after the individual becomes non-infectious.
Conclusion:
The cases presented here had COVID other than COVID-19, caused by coronavirus variants other than SARS-CoV-2. Co-infections with other pathogens are present in these "Non- COVID-19" COVIDs. PCR testing of non-COVID-19 COVIDs may help in the accurate diagnosis of these ailments and respiratory co-infections.
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