A cautionary tale of false-negative nasopharyngeal COVID-19 testing

Bullis, Sean; Crothers, Jessica W; Wayne, Shawn; Hale, Andrew J.

doi:10.1016/j.idcr.2020.e00791

Cited by 29 publications

(32 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since there is still diagnostic uncertainty regarding the sensitivity of reverse transcription polymerase chain reaction in detection of SARS-CoV-2 from nasopharyngeal specimens, a single negative result may be insufficient to rule-out disease. 6 The peculiarity of our case is that in our patient skin lesions appeared as the first manifestation of the infection, 10 days before the F I G U R E 1 Coalescing erythematous patches on the patient's trunk and thighs, with some scattered targetoid lesions…”

mentioning

confidence: 73%

A fatal case of COVID ‐19 infection presenting with an erythema multiforme‐like eruption and fever

Gargiulo

Pavia

Facheris

et al. 2020

Dermatologic Therapy

View full text Add to dashboard Cite

onset of any respiratory symptoms. As stated by von Damme et al, 7 clinicians should be aware that a febrile cutaneous rash can be the first sign of COVID-19 infection. As dermatologists, we have to promote among other specialists the potential recognition of the possible cutaneous presentations of COVID-19, including uncommon manifestations, and lead to think about testing and/or retesting COVID-19.

show abstract

mentioning

confidence: 73%

A fatal case of COVID ‐19 infection presenting with an erythema multiforme‐like eruption and fever

Gargiulo

Pavia

Facheris

et al. 2020

Dermatologic Therapy

View full text Add to dashboard Cite

show abstract

“…Limitations include the suboptimal sensitivity of nasopharyngeal and oropharyngeal swabs for SARS-CoV-2. 31 The lack of reliable serology during the pandemic also meant that cases could not be confirmed retrospectively. Important questions still remain unanswered.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

COVID-19 in children: analysis of the first pandemic peak in England

et al. 2020

View full text Add to dashboard Cite

ObjectivesTo assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England.SettingEngland.ParticipantsChildren with COVID-19 between January and May 2020.Main outcome measuresTrends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years.ResultsChildren represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%–34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%–45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children.ConclusionsChildren accounted for a very small proportion of confirmed cases despite the large numbers of children tested. SARS-CoV-2 positivity was low even in children with ARI. Our findings provide further evidence against the role of children in infection and transmission of SARS-CoV-2.

show abstract

“…Currently, nucleic acid amplification tests (NAATs) of nasopharyngeal swabs are the primary method used to identify SARS-CoV-2-infected individuals 2 . These tests can diagnose disease during a narrow window of active infection and have limited clinical sensitivity [4][5][6][7] . Thus, additional complementary methods are needed to identify individuals who are or have been infected with SARS-CoV-2.…”

mentioning

confidence: 99%

Ultrasensitive high-resolution profiling of early seroconversion in patients with COVID-19

et al. 2020

View full text Add to dashboard Cite

Sensitive assays are essential for the accurate identification of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we report a multiplexed assay for the fluorescence-based detection of seroconversion in infected individuals from less than 1 µl of blood, and as early as the day of the first positive nucleic acid test after symptom onset. The assay uses dye-encoded antigen-coated beads to quantify the levels of immunoglobulin G (IgG), IgM and IgA antibodies against four SARS-CoV-2 antigens. A logistic regression model trained using samples collected during the pandemic and samples collected from healthy individuals and patients with respiratory infections before the first outbreak of coronavirus disease 2019 (COVID-19) was 99% accurate in the detection of seroconversion in a blinded validation cohort of samples collected before the pandemic and from patients with COVID-19 five or more days after a positive nasopharyngeal test by PCR with reverse transcription. The high-throughput serological profiling of patients with COVID-19 allows for the interrogation of interactions between antibody isotypes and viral proteins, and should help us to understand the heterogeneity of clinical presentations.

show abstract

A cautionary tale of false-negative nasopharyngeal COVID-19 testing

Cited by 29 publications

References 8 publications

A fatal case of COVID ‐19 infection presenting with an erythema multiforme‐like eruption and fever

A fatal case of COVID ‐19 infection presenting with an erythema multiforme‐like eruption and fever

COVID-19 in children: analysis of the first pandemic peak in England

Ultrasensitive high-resolution profiling of early seroconversion in patients with COVID-19

Contact Info

Product

Resources

About