False-negative testing for severe acute respiratory syndrome coronavirus 2: consideration in obstetrical care

Am J Obstet Gynecol MFM. 2020 Aug;2(3):100130. doi: 10.1016/j.ajogmf.2020.100130. Epub 2020 Apr 28.

Abstract

Because the obstetrical population seems to have a high proportion of asymptomatic patients who are carriers of severe acute respiratory syndrome coronavirus 2, universal testing has been proposed as a strategy to risk-stratify all obstetrical admissions and guide infection prevention protocols. Here, we describe a case of a critically ill obstetrical patient with all the clinical symptoms of coronavirus disease 2019 and 3 false-negative results of nasopharyngeal swabs for molecular testing. We review and discuss the uncertain clinical characteristics of current severe acute respiratory syndrome coronavirus 2 molecular testing and the implications of false-negative results in the obstetrical population.

Keywords: COVID-19; SARS-CoV-2; coronavirus; diagnostic test sensitivity; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bronchoalveolar Lavage Fluid / virology*
  • COVID-19 Testing / methods*
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Cesarean Section / methods
  • Critical Care / methods
  • False Negative Reactions*
  • Female
  • Humans
  • Infection Control / methods*
  • Obstetrics and Gynecology Department, Hospital / organization & administration*
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Complications, Infectious* / virology
  • Respiration, Artificial
  • Risk Adjustment / methods
  • SARS-CoV-2 / isolation & purification*
  • Severity of Illness Index
  • Treatment Outcome