Survival in adult pneumonia inpatients fulfilling suspected CoViD-19 criteria and baseline negative RT-qPCR

Murillo-Zamora, Efrén; Mendoza-Cano, Oliver; Cárdenas-Rojas, Martha I.; Hernandez-Suarez, Carlos M.; Guzmán-Esquivel, José

Objective To evaluate the survival experience of suspicion COVID-19 hospitalized patients with pneumonia and negative baseline RT-qPCR test results. Study design We conducted a nationwide retrospective cohort study in Mexico. Method Adult pneumonia inpatients fulfilling suspected COVID-19 criteria, and hospital entry from March to August 2020, were enrolled. The Kaplan-Meier method was to use to compare survival estimates among patients with negative RT-qPCR nasopharyngeal or oropharyngeal swabs and those with a baseline positive test. Results Data from 64,624 individuals fulfilling suspected CoViD-19 criteria were analyzed and 1.6% of them had negative RT-qPCR tests. The overall mortality rate was higher among laboratory-positive patients (48.5% vs. 34.2%, p < 0.001) and, at any given threshold, the survival estimates were higher among RT-qPCR negative pneumonia inpatients. Conclusions The pathogenic mechanism of COVID-19 remains poorly understood and suspected cases with pneumonia and negative laboratory results represent a major challenge for healthcare systems. Our findings suggest that RT-qPCR negative inpatients may have an improved disease prognosis but the in-hospital mortality was still high among them. However, further research is needed to clarify the clinical and epidemiological implications of our results.