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

Li, Dasheng; Wang, Dawei; Dong, Jianping; Wang, Nana; Huang, He; Xu, Haiwang; Xia, Chen

Since rRT-PCR tests serve as the gold standard method to confirm the infection of SARS-CoV-2, false-negative results could hinder the prevention and control of the epidemic, particularly when this test plays a key reference role in deciding the necessity for continued isolated medical observation or discharge. Regarding the (3). We speculated from these two cases that infection routes, disease progression status (specimen collection timing and methods), and coinfection with other viruses might influence the rRT-PCR test accuracy, which should be further studied with more cases. False-negative rRT-PCR results were seen in many hospitals. By monitoring data collected at our hospital from January 21 to 31, 2020, two out of ten negative cases shown by the rRT-PCR test were finally confirmed to be positive for COVID-19, yielding an approximately 20% false-negative rate of rRT-PCR. Although the false-negative estimate would not be accurate until we expand the observational time span and number of monitored cases, the drawback of rRT-PCR was revealed. Clinical manifestations, laboratory examination results, and chest CT features of patients with COVID-19 were also of great value in helping the detection and diagnosis. Thus, an integrated criterion should be established for the diagnosis of SARS-CoV-2 infection. In addition to the epidemiological information, we focused on two aspects of information: chest CT features and laboratory examination results.