The clinical sensitivity of a single SARS-CoV-2 upper respiratory tract RT-PCR test for diagnosing COVID-19 using convalescent antibody as a comparator

Clin Med (Lond). 2020 Nov;20(6):e209-e211. doi: 10.7861/clinmed.2020-0555. Epub 2020 Sep 11.

Abstract

The clinical false negative rate of reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 on a single upper respiratory tract sample was calculated using convalescent antibody testing as a comparator. The sensitivity in symptomatic individuals was 86.2% (25/29). Of the missed cases, one (3.5%) was detected by repeat RT-PCR, one by CT thorax and two (7.1%) by convalescent antibody. The clinical false negative rate of a single RT-PCR on an upper respiratory tract sample of 14% in symptomatic patients is reassuring when compared to early reports. This report supports a strategy of combining repeat swabbing, use of acute and convalescent antibody testing and CT thorax for COVID-19 diagnosis.

Keywords: COVID-19; COVID-19 antibody; SARS-CoV-2 RT-PCR; clinical sensitivity.

MeSH terms

  • Antibodies, Viral / blood
  • Asymptomatic Infections
  • Betacoronavirus / genetics
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques* / standards
  • Clinical Laboratory Techniques* / statistics & numerical data
  • Coronavirus Infections / blood
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / immunology
  • Coronavirus Infections / virology
  • False Negative Reactions
  • Humans
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / virology
  • Reverse Transcriptase Polymerase Chain Reaction* / standards
  • Reverse Transcriptase Polymerase Chain Reaction* / statistics & numerical data
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Thorax / virology

Substances

  • Antibodies, Viral