Elsevier

Annals of Medicine and Surgery

Volume 59, November 2020, Pages 224-228
Annals of Medicine and Surgery

Prolonged nucleic acid conversion and false-negative RT-PCR results in patients with COVID-19: A case series

https://doi.org/10.1016/j.amsu.2020.09.040Get rights and content
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open access

Highlights

  • Prolonged nucleic acid conversion in patients with COVID-19 from Indonesia, becoming the longest reported of 70 days.

  • We further confirmed the occurrence of prolonged nucleic acid conversion and false negative RT-PCR in COVID-19 patients.

  • Several factors might affect the prolonged nucleic acid conversion, including older age and comorbidities.

Abstract

Background

Prolonged nucleic acid conversion and false-negative real-time polymerase chain reaction (RT-PCR) results might occur in COVID-19 patients rather than infection recurrence.

Presentation of cases

We reported four cases who had negative RT-PCR results, in addition to the last two consecutive negative results. Patient-1 had negative RT-PCR results twice (the 6th and 8th) from a total of 11 swabs. Patient-2 had negative RT-PCR results once (the 5th) from a total of 8 swabs. Patient-3 showed negative results of RT-PCR twice (the 4th and 6th) from a total of 11 swabs. Patient-4 had negative RT-PCR results twice (the 2nd and 10th) from a total of 14 swabs.

Discussion

The fluctuating trend of our RT-PCR results in our cases might be due to insufficient viral material in the specimen, laboratory errors during sampling, restrictions on sample transportation, or mutations in the primary and probe target regions in the SARS-CoV-2 genome. Several factors might affect the occurrence of prolonged nucleic acid conversion, including older age, comorbidities, such as diabetes and hypertension, and impaired immune function.

Conclusion

Here, we confirmed the occurrence of prolonged nucleic acid conversion and the possibility of false negative RT-PCR results in COVID-19 patients.

Keywords

COVID-19
Case series
False negative of RT-PCR
Prolonged nucleic acid conversion
SARS-Cov-2

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