Routine blood analysis greatly reduces the false-negative rate of RT-PCR testing for Covid-19.
Keywords:
COVID-19, RT-PCR, blood test, WBC, aspartate aminotransferase, lactate dehydrogenaseAbstract
Background: The COVID-19 outbreak is now a pandemic disease reaching as much as 210 countries worldwide with more than 2.5 million infected people and nearly 200.000 deaths. Amplification of viral RNA by RT-PCR represents the gold standard for confirmation of infection, yet it showed false-negative rates as large as 15-20% which may jeopardize the effect of the restrictive measures taken by governments. We previously showed that several hematological parameters were significantly different between COVID-19 positive and negative patients. Among them aspartate aminotransferase and lactate dehydrogenase had predictive values as large as 90%. Thus a combination of RT-PCR and blood tests could reduce the false-negative rate of the genetic test. Methods: We retrospectively analyzed 24 patients showing multiple and inconsistent RT-PCR, test during their first hospitalization period, and compared the genetic tests results with their AST and LDH levels. Results: We showed that when considering the hematological parameters, the RT-PCR false-negative rates were reduced by almost 4-fold. Conclusions: The study represents a preliminary work aiming at the development of strategies that, by combining RT-PCR tests with routine blood tests, will lower or even abolish the rate of RT-PCR false-negative results and thus will identify, with high accuracy, patients infected by COVID-19.
References
Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020.
Pandemic C-19 C. No Title [Internet]. Available from: https://www.worldometers.info/coronavirus/
Day M. Covid-19: identifying and isolating asymptomatic people helped eliminate virus in Italian village. Bmj [Internet]. 2020;368. Available from: https://www.bmj.com/content/368/bmj.m1165.long
Li Y, Yao L, Li J, Chen L, Song Y, Cai Z, et al. Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19. J Med Virol. 2020;
Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020;
Li D, Wang D, Dong J, Wang N, Huang H, Xu H, et al. False-Negative Results of Real-Time Reverse-Transcriptase Polymerase Chain Reaction for Severe Acute Respiratory Syndrome Coronavirus 2: Role of Deep-Learning-Based CT Diagnosis and Insights from Two Cases. Korean J Radiol [Internet]. 2020;21(4):505. Available from: https://synapse.koreamed.org/DOIx.php?id=10.3348/kjr.2020.0146
Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C, et al. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT? Eur J Radiol [Internet]. 2020;126(March):108961. Available from: https://doi.org/10.1016/j.ejrad.2020.108961
Lippi G, Simundic A-M, Plebani M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). Clin Chem Lab Med. 2020;0(0).
Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;
Pan Y, Long L, Zhang D, Yan T, Cui S, Yang P, et al. Potential false-negative nucleic acid testing results for Severe Acute Respiratory Syndrome Coronavirus 2 from thermal inactivation of samples with low viral loads. Clin Chem. 2020;
Yi H. 2019 novel coronavirus is undergoing active recombination. Clin Infect Dis. 2020;
Li D, Wang D, Dong J, Wang N, Huang H, Xu H, et al. False-negative results of real-time reverse-transcriptase polymerase chain reaction for severe acute respiratory syndrome coronavirus 2: Role of deep-learning-based ct diagnosis and insights from two cases. Korean J Radiol. 2020;21(4):505–8.
Ferrari D, Motta A, Strollo M, Banfi G, Locatelli M. Routine blood tests as a potential diagnostic tool for COVID-19. Clin Chem Lab Med [Internet]. 2020;1–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/32301746
Ferrari D, Lombardi G, Strollo M, Pontillo M, Motta A, Locatelli M. Association between solar ultraviolet doses and vitamin D clinical routine data in European mid-latitude population between 2006 and 2018. Photochem Photobiol Sci. 2019;18(11):2696–706.
Ferrari D, Ripa M, Premaschi S, Banfi G, Castagna A, Locatelli M. LC-MS/MS method for simultaneous determination of linezolid, meropenem, piperacillin and teicoplanin in human plasma samples. J Pharm Biomed Anal. 2019;
Ferrari D, Strollo M, Vidali M, Motta A, Pontillo M, Locatelli M. Biochemical, immunochemical and serology analytes validation of the lithium heparin BD Barricor blood collection tube on a highly automated Roche COBAS8000 instrument. Acta Biomed. 2020;91(1):47–55.
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