scholarly journals Laboratory markers included in the Corona Score can identify false negative results on COVID-19 RT-PCR in the emergency room

2020 ◽  
Vol 30 (3) ◽  
pp. 357-359
Author(s):  
Roberto Assandri ◽  
Ciro Canetta ◽  
Giovanni Viganò ◽  
Elisabetta Buscarini ◽  
Alessandro Scartabellati ◽  
...  
Keyword(s):  
Emergency Room ◽  
False Negative ◽  
Clinical Syndrome ◽  
The Novel ◽  
Emergency Rooms ◽  
Negative Results ◽  
Emergency Room Patients ◽  
False Negative Results ◽  
Wide Range ◽  
Novel Coronavirus

After December 2019 outbreak in China, the novel Coronavirus infection (COVID-19) has very quickly overflowed worldwide. Infection causes a clinical syndrome encompassing a wide range of clinical features, from asymptomatic or oligosymptomatic course to acute respiratory distress and death. In a very recent work we preliminarily observed that several laboratory tests have been shown as characteristically altered in COVID-19. We aimed to use the Corona score, a validated point-based algorithm to predict the likelihood of COVID-19 infection in patients presenting at the Emergency rooms. This approach combines chest images-relative score and several laboratory parameters to classify emergency room patients. Corona score accuracy was satisfactory, increasing the detection of positive patients’ rate.

scholarly journals An Overview of Nucleic Acid Testing for the Novel Coronavirus SARS-CoV-2

2021 ◽  
Vol 7 ◽  
Author(s):  
Huiling Wang ◽  
Gang Li ◽  
Jing Zhao ◽  
Yanjie Li ◽  
Yushu Ai
Keyword(s):  
Nucleic Acid ◽  
Early Diagnosis ◽  
Treatment Plan ◽  
False Negative ◽  
Nucleic Acid Testing ◽  
The Novel ◽  
Negative Results ◽  
Literature Overview ◽  
False Negative Results ◽  
Novel Coronavirus

In this note we analyze the problems in the nucleic acid testing (NAT) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and we also give some suggestions for improving the accuracy of NAT diagnosis. NAT testing is considered to be the diagnostic “gold standard”; at present there are few reviews on NAT for SARS-CoV-2. Moreover, many false-negative results always appear in the procedure of detecting, which has affected early diagnosis of the disease and brought a great challenge to mitigation and containment of the pandemic. In conclusion, comprehensive analyses of serological and imaging findings should be performed to guide the formulation of an accurate clinical diagnosis, treatment plan, and monitoring therapeutic efficacy, in an effort to achieve early diagnosis, containment, and treatment of the disease, thereby effectively reducing progression of the pandemic. This article presents a literature overview of SARS-CoV-2 nucleic acid testing, aiming to provide support for clinicians.

scholarly journals Limitations of a Commercial Assay as Diagnostic Test of Autoimmune Encephalitis

2021 ◽  
Vol 12 ◽  
Author(s):  
Raquel Ruiz-García ◽  
Guillermo Muñoz-Sánchez ◽  
Laura Naranjo ◽  
Mar Guasp ◽  
Lidia Sabater ◽  
...  
Keyword(s):  
False Negative ◽  
Autoimmune Encephalitis ◽  
Clinical Syndrome ◽  
The Other ◽  
Transfected Cells ◽  
Negative Results ◽  
Clinical Laboratories ◽  
False Negative Results ◽  
Number Of Patients ◽  
Separate Cohort

Detection of neuronal surface antibodies (NSAb) is important for the diagnosis of autoimmune encephalitis (AE). Although most clinical laboratories use a commercial diagnostic kit (Euroimmun, Lübeck, Germany) based on indirect immunofluorescence on transfected cells (IIFA), clinical experience suggests diagnostic limitations. Here, we assessed the performance of the commercial IIFA in serum and CSF samples of patients with suspected AE previously examined by rat brain immunohistochemistry (Cohort A). Of 6213 samples, 404 (6.5%) showed brain immunostaining suggestive of NSAb: 163 (40%) were positive by commercial IIFA and 241 (60%) were negative. When these 241 samples were re-assessed with in-house IIFA, 42 (18%) were positive: 21 (9%) had NSAb against antigens not included in the commercial IIFA and the other 21 (9%) had NSAb against antigens included in the commercial kit (false negative results). False negative results occurred more frequently with CSF (29% vs 10% in serum) and predominantly affected GABABR (39%), LGI1 (17%) and AMPAR (11%) antibodies. Results were reproduced in a separate cohort (B) of 54 AE patients with LGI1, GABABR or AMPAR antibodies in CSF which were missed in 30% by commercial IIFA. Patients with discordant GABABR antibody results (positive in-house but negative commercial IIFA) were less likely to develop full-blown clinical syndrome; no significant clinical differences were noted for the other antibodies. Overall, NSAb testing by commercial IIFA led to false negative results in a substantial number of patients, mainly those affected by anti-LG1, GABABR or AMPAR encephalitis. If these disorders are suspected and commercial IIFA is negative, more comprehensive antibody studies are recommended.

scholarly journals Novel coronavirus infection COVID-19: extrapulmonary manifestations

2020 ◽  
Vol 92 (8) ◽  
pp. 4-11 ◽  
Author(s):  
I. V. Maev ◽  
A. V. Shpektor ◽  
E. Yu. Vasilyeva ◽  
V. N. Manchurov ◽  
D. N. Andreev
Keyword(s):  
Arterial Thrombosis ◽  
Respiratory Symptoms ◽  
Myocardial Damage ◽  
Cardiovascular Complications ◽  
Clinical Syndrome ◽  
The Novel ◽  
Wide Range ◽  
Serum Transaminases ◽  
Coronavirus Infection ◽  
Novel Coronavirus

The novel coronavirus infection COVID-19 in most cases manifests with respiratory symptoms and fever, however, some patients may have cardiovascular and gastroenterological manifestations. A feature of the clinical syndrome of COVID-19 is the development of pronounced immunopathological reactions and disorders of hemostasis, leading to the development of a wide range of cardiovascular complications. The course of COVID-19 may be complicated by the development of acute myocardial infarction, venous and arterial thrombosis and thromboembolism in various vascular pools, the development of acute myocardial damage and myocarditis. Among the gastroenterological manifestations, diarrhea, nausea or vomiting, as well as abdominal pain, are most often detected. These symptoms may precede the appearance of respiratory signs of the disease, and in some cases come to the fore in the clinical picture of the disease. In addition, in some patients there are laboratory signs of liver injury (increased serum transaminases). The exact pathogenesis of the above disorders continues to be studied.

scholarly journals Conjunctival polymerase chain reaction-tests of 2019 novel coronavirus in patients in Shenyang,China

2020 ◽  
Author(s):  
Li Xu ◽  
Xinyue Zhang ◽  
Wei Song ◽  
Baijun Sun ◽  
Jinping Mu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
False Negative ◽  
Suspected Case ◽  
Negative Results ◽  
False Negative Results ◽  
Laboratory Results ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Negative Detection

Abstract Background We report the laboratory results of conjunctival PCR-tests and some clinical features of these patients infected with COVID-19 in shenyang China.Methods We collected conjunctival samples of the patients to do the laboratory tests by PCR.Medical observed patients were enrolled if they had clinical symptoms. Then we analysed the PCR results and clinical features in order to find some relationships.Results The study include 14 confirmly diagnosed cases ,16 suspected cases and some medical observed patients.1 of the identified case coverted from suspected case.22 medical observed cases were removed because none of them converted to identified cases.1 of the suspected converted to identified case recently.All the conjunctival results of PCR-test were negative.Discussion The reasons of the negative detection results of PCR in conjunctival swabs were discussed.Conclusion Conjunctiva may be a transmission way of COVID-19.And ocular conjunctival swabs could be a diagnostic method for identifying the infection of COVID-19.Emphasis on the false-negative results is vital.

scholarly journals Conjunctival polymerase chain reaction-tests of 2019 novel coronavirus in patients in Shenyang, China

2020 ◽  
Author(s):  
Li Xu ◽  
Xinyue Zhang ◽  
Wei Song ◽  
Baijun Sun ◽  
Jinping Mu ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Randomized Study ◽  
False Negative ◽  
Suspected Case ◽  
Cross Sectional ◽  
Negative Results ◽  
False Negative Results ◽  
Imported Cases ◽  
Novel Coronavirus ◽  
Pcr Test

AbstractPurposeThe 2019 novel coronavirus(COVID-19) mainly transmitted by person-to-person through inhalation of respiratory droplets. We report the laboratory results of conjunctival PCR-tests and some clinical features of these patients in shenyang China.DesignThis is a cross-sectional non-randomized studySubjectsThe study include 14 confirmly diagnosed cases, 16 suspected cases and some medical observed patients.MethodsAll patients with diagnosed and suspected COVID-19 were admitted to a designated hospital in Shenyang, China. We collected conjunctival samples of these patients to do the laboratory tests by real time RT-PCR. Medical observed patients were enrolled if they had clinical symptoms. Then we analysed the PCR results and clinical data from eletronic medical records in order to find some relationships.Main Outcome MeasuresClinical condition and PCR results. of conjunctival swabs compared with other specimensResultsOne of the identified case coverted from suspected case without typical clinical symptoms. Twenty-two medical observed cases were removed because none of them converted to identified cases. One of the suspected converted to identified case recently. The included cases in our study are imported cases with less underlying diseases and the severity of their infection was relatively moderate. All the conjunctival results of PCR-test were negative. Two cases had typical clinical symptoms but were finally confirmed by repeated pharynxswabtests.ConclusionConjunctiva may be a transmission way of COVID-19. And ocular conjunctival swabs in combination with PCR test could be a non-invasive, convenient and feasible diagnostic method for identifying the infection of COVID-19. Emphasis on the false-negative results is vital.

scholarly journals Screening Method to Evaluate Point-of-Care Human Chorionic Gonadotropin (hCG) Devices for Susceptibility to the Hook Effect by hCG β Core Fragment: Evaluation of 11 Devices

2014 ◽  
Vol 60 (4) ◽  
pp. 667-674 ◽  
Author(s):  
Robert D Nerenz ◽  
Haowei Song ◽  
Ann M Gronowski
Keyword(s):  
Chorionic Gonadotropin ◽  
Healthcare Professionals ◽  
Point Of Care ◽  
False Negative ◽  
Screening Method ◽  
Core Fragment ◽  
Negative Results ◽  
Hook Effect ◽  
False Negative Results ◽  
Wide Range

Abstract BACKGROUND The predominant hCG variant in urine, hCG β core fragment (hCGβcf), has been demonstrated to cause false-negative results in qualitative point-of-care (POC) hCG devices. This is a major concern for healthcare professionals using POC pregnancy tests. We developed a screening method to evaluate qualitative POC hCG devices for their susceptibility to inhibition by hCGβcf. Using this method, we evaluated the performance of 11 commonly used devices. METHODS A wide range of purified hCG and hCGβcf concentrations were mixed and tested on 2 POC devices. By use of those results, a screening method was defined and 9 additional POC devices were evaluated. Two solutions containing (a) 500 pmol/L (171 IU/L) intact hCG with 0 pmol/L hCGβcf and (b) 500 pmol/L intact hCG with 500 000 pmol/L hCGβcf were used to screen all POC devices. RESULTS The OSOM and Cen-Med Elite devices were found to be most susceptible to false-negative results due to hCGβcf. The BC Icon 20 and the Alere were the least susceptible. The remaining 7 were moderately affected. Devices that gave the strongest signal with hCGβcf alone were those that were least likely to show a hook effect. CONCLUSIONS The screening method put forth here can be used by device users and manufacturers to evaluate POC devices for inhibition by hCGβcf. Of 11 devices evaluated, only 2 have been identified that exhibit minimal to no susceptibility to hCGβcf.

Critical Evaluation of Impedance Phlebography for the Diagnosis of Deep Vein Thrombosis

1974 ◽  
Vol 31 (02) ◽  
pp. 273-278
Author(s):  
Kenneth K Wu ◽  
John C Hoak ◽  
Robert W Barnes ◽  
Stuart L Frankel
Keyword(s):  
Deep Vein Thrombosis ◽  
False Positive ◽  
False Negative ◽  
Critical Evaluation ◽  
Original Method ◽  
Vein Thrombosis ◽  
Negative Results ◽  
False Negative Results ◽  
Deep Vein ◽  
Positive Results

SummaryIn order to evaluate its daily variability and reliability, impedance phlebography was performed daily or on alternate days on 61 patients with deep vein thrombosis, of whom 47 also had 125I-fibrinogen uptake tests and 22 had radiographic venography. The results showed that impedance phlebography was highly variable and poorly reliable. False positive results were noted in 8 limbs (18%) and false negative results in 3 limbs (7%). Despite its being simple, rapid and noninvasive, its clinical usefulness is doubtful when performed according to the original method.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

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