The Clinical and Radiological Manifestations in Coronavirus Disease (COVID-19) with Negative Nucleic Acid Results

Lang, Guanjing; Su, Junwei; Wu, Wenrui; Zhao, Hong; Ying, Shihong; Lou, Haiyan; Shen, Xiaomin; Yin, Michael T; Xu, Kaijin; Liu, Jun; Ren, Cheng; Sheng, Jifang

BACKGROUND: COVID-19 was a new emerging disease with high infectiousness. Its diagnosis primarily depended on real time-polymerase chain reaction (RT-PCR) results. This study investigated epidemiological, clinical and radiological characteristics of COVID-19 with negative RT-PCR results before confirmation. METHODS: COVID-19 patients were enrolled and divided into two groups, negative group with negative RT-PCR results before confirmation and positive group with positive results at the first detection. Epidemiological and clinical features were compared. Dynamic chest CT images of negative group were evaluated. RESULT: Nighty-nine laboratory-confirmed COVID-19 including eight patients (8%) with negative RT-PCR results were included. Patients from negative group had similar epidemiological features as the average age (50.25±13.27 y in the negative group and 53.70±16.64 y in the positive group) and gender distribution (males made up 50% of the negative group and 62.6% of the positive group) were comparable. No significant difference of clinical symptoms were observed between the two groups. It was found that fever was the most common symptom for both groups, followed by cough, expectoration, chest distress, fatigue and gastroenterological symptoms. Moreover, ground-glass opacities and consolidations were main manifestations in chest CT of COVID-19 patients with or without confirmed RT-PCR results. CONCLUSIONS: Regardless of initial RT-PCR results, COVID-19 patients had similar epidemiological, clinical and chest CT features. Our study suggested values of early chest CT scan in COVID-19 screening and dynamic significance of radiology in disease monitoring to guide clinical decision.