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Use of Rapid Antibody Test in 3 patients with suspected Coronovirus Disease-19 (COVID-19) with 2 time Polymerase Chain Reaction (PCR) test negative: A case report

Year 2020, Volume: 42 Issue: 2, 208 - 212, 21.07.2020
https://doi.org/10.7197/cmj.vi.747330

Abstract

Tests used to diagnose Coronavirus Disease-2019 (COVID-19) disease; Polymerase Chain Reaction (PCR) test, Rapid Antibody Test (RAT) and Thorax Computed Tomography (CT) in patients with appropriate history, clinical and laboratory. The sensitivity of these tests changes during the course of the disease and it is difficult to diagnose if the appropriate test is not selected at the appropriate time.
PCR test was applied to 3 cases who applied to our hospital and had findings suggesting COVID-19 in CT, and all tests were negative. Afterwards, 3 cases diagnosed with RAT and COVID-19 were treated appropriately.
These 3 cases showed that PCR test negativity is not an adequate criterion to rule out the disease. Even if the PCR test is negative in patients with appropriate history and clinic, RAT and / or CT should be performed considering the time elapsed since the onset of the patient's symptoms.

References

  • Referans1 Kazuo Imai, Sakiko Tabata, Mayu Ikeda, Sakiko Noguchi, Yutaro Kitagawa, Masaru Matuoka, Kazuyasu Miyoshi, Norihito Tarumoto, Jun Sakai, Toshimitsu Ito, Shigefumi Maesaki, Kaku Tamura, Takuya Maeda. Clinical evaluation of an immunochromatographic IgM/IgG antibody assay and chest computed tomography for the diagnosis of COVID-19 J Clin Virol. 2020 Jul; 128: 104393. Published online 2020 Apr 30. doi: 10.1016/j.jcv.2020.104393 Referans2 Harrison X. Bai, Ben Hsieh, Zeng Xiong , Kasey Halsey, Ji Whae Choi, Thi My Linh Tran Ian Pan, Lin-Bo Shi, Dong-Cui Wang, Ji Mei, Xiao-Long Jiang, Qiu-Hua Zeng, Thomas K. Egglin, Ping-Feng Hu8, Saurabh Agarwal, Fangfang Xie, Sha Li, Terrance Healey, Michael K. Atalay, Wei-Hua Liao. Performance of radiologists in di erentiating COVID-19 from viral pneumonia on chest CT, Radiology (2020), https://doi.org/10.1148/radiol.2020200823. Referans3 P. Huang, T. Liu, L. Huang, H. Liu, M. Lei, W. Xu, Use of chest CT in com- bination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion, Radiology (2020), https://doi.org/10.1148/radiol. 2020200330:200330. Referans4 Juanjuan Zhao, Quan Yuan, Haiyan Wang, Wei Liu, Xuejiao Liao, Yingying Su, Xin Wang, Jing Yuan, Tingdong Li, Jinxiu Li, Shen Qian, Congming Hong, Fuxiang Wang, Yingxia Liu, Zhaoqin Wang, Qing He, Zhiyong Li, Bin He, Tianying Zhang, Yang Fu, Shengxiang Ge, Lei Liu, Jun Zhang, Ningshao Xia, Zheng Zhang. Antibody responses to SARS-COV-2 in patients of novel coronavirus disease 2019. DOI: 10.1093/cid/ciaa344. Referans5 Wei-jie Guan, Zheng-yi Ni, Yu Hu, Wen-hua Liang, Chun-quan Ou, Jian-xing He, Lei Liu, Hong Shan, Chun-liang Lei, David S.C. Hui, Bin Du, Lan-juan Li, Guang Zeng, Kwok-Yung Yuen, Ru-chong Chen, Chun-li Tang, Tao Wang, Ping-yan Chen, Jie Xiang, Shi-yue Li, Jin-lin Wang, Zi-jing Liang, Yi-xiang Peng, Li Wei, Yong Liu, Ya-hua Hu, Peng Peng, Jian-ming Wang, Ji-yang Liu, Zhong Chen, Gang Li, Zhi-jian Zheng, Shao-qin Qiu, Jie Luo, Chang-jiang Ye, Shao-yong Zhu, Nan-shan Zhong. Clinical characteristics of 2019 novel coronavirus infection in China. N Engl J Med. DOI: 10.1056/NEJMoa2002032 Referans6 Ming Wang, Qing Wu, Wanzhou Xu, Bin Qiao, Jingwei Wang, Hongyun Zheng, Shupeng Jiang, Junchi Mei, Zegang Wu, Yayun Deng, Fangyuan Zhou, Wei Wu, Yan Zhang, Zhihua Lv, Jingtao Huang, Xiaoqian Guo, Lina Feng, Zunen Xia, Di Li, Zhiliang Xu, Tiangang Liu, Pingan Zhang, Yongqing Tong, Yan Li. Clinical Diagnosis of 8274 samples with 2019-novel coronavirus in Wuhan. medRxiv 2020; published online Feb 18. DOI:10.1101/2020.02.12.20022327. Referans7 Marie-Pierre Revel, Anagha P. Parkar, Helmut Prosch, Mario Silva, Nicola Sverzellati, Fergus Gleeson, Adrian Brady. European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI). Eur Radiol. 2020 Apr 20. doi: 10.1007/s00330-020-06865-y. Referans8 Luca Spiezia, Annalisa Boscolo, Francesco Poletto, Lorenzo Cerruti, Ivo Tiberio, Elena Campello, Paolo Navalesi, Paolo Simioni. COVID-19-Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure2020 Apr 21. doi: 10.1055/s-0040-1710018. Referans9 Chaolin Huang, Yeming Wang, Xingwang Li, Lili Ren, Jianping Zhao, Yi Hu, Li Zhang, Guohui Fan, Jiuyang Xu, Xiaoying Gu, Zhenshun Cheng, Ting Yu, Jiaan Xia, Yuan Wei, Wenjuan Wu, Xuelei Xie, Wen Yin, Hui Li, Min Liu, Yan Xiao, Hong Gao, Li Guo, Jungang Xie, Guangfa Wang, Rongmeng Jiang, Zhancheng Gao, Qi Jin, Jianwei Wang, Bin Cao. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet 395 (2020) 497–506.

2 Kez Polymerase Chain Reaction (PCR) Testi negatif sonuçlanan Coronovirus Disease-19 (COVİD-19) şüpheli 3 hastada hızlı antikor testinin kullanımı: Olgu sunumu

Year 2020, Volume: 42 Issue: 2, 208 - 212, 21.07.2020
https://doi.org/10.7197/cmj.vi.747330

Abstract

Coronavirus Disease-2019 (COVİD-19) hastalığının tanısını koymak için kullanılan testler; uygun öykü, klinik ve laboratuvara sahip hastalarda Polymerase Chain Reaction (PCR) testi, Hızlı Antikor Testi (HAT) ve Toraks Bilgisayarlı Tomografi (BT)'den oluşmaktadır. Bu testlerin duyarlılıkları, hastalığın seyri sırasında değişmekte ve uygun zamanda uygun test seçilmediği taktirde tanının konulması zorlaşmaktadır. 
Hastanemize başvuran ve BT'de COVİD-19 düşündüren bulgulara sahip olan 3 vakamıza PCR testi uygulanmış olup, tüm testler negatif gelmiştir. Daha sonrasında yapılan HAT ile COVİD-19 tanısı kesinleştirilen 3 vaka uygun şekilde tedavi edilmiştir.
Bu 3 vaka göstermiştir ki PCR testi negatifliği hastalığı dışlamak için yeterli bir kriter değildir. Uygun öykü ve kliniği olan hastalarda PCR testi negatif dahi olsa, hastanın semptomlarının başlangıcından itibaren geçen süre dikkate alınarak HAT ve/veya BT uygulanmalıdır.

References

  • Referans1 Kazuo Imai, Sakiko Tabata, Mayu Ikeda, Sakiko Noguchi, Yutaro Kitagawa, Masaru Matuoka, Kazuyasu Miyoshi, Norihito Tarumoto, Jun Sakai, Toshimitsu Ito, Shigefumi Maesaki, Kaku Tamura, Takuya Maeda. Clinical evaluation of an immunochromatographic IgM/IgG antibody assay and chest computed tomography for the diagnosis of COVID-19 J Clin Virol. 2020 Jul; 128: 104393. Published online 2020 Apr 30. doi: 10.1016/j.jcv.2020.104393 Referans2 Harrison X. Bai, Ben Hsieh, Zeng Xiong , Kasey Halsey, Ji Whae Choi, Thi My Linh Tran Ian Pan, Lin-Bo Shi, Dong-Cui Wang, Ji Mei, Xiao-Long Jiang, Qiu-Hua Zeng, Thomas K. Egglin, Ping-Feng Hu8, Saurabh Agarwal, Fangfang Xie, Sha Li, Terrance Healey, Michael K. Atalay, Wei-Hua Liao. Performance of radiologists in di erentiating COVID-19 from viral pneumonia on chest CT, Radiology (2020), https://doi.org/10.1148/radiol.2020200823. Referans3 P. Huang, T. Liu, L. Huang, H. Liu, M. Lei, W. Xu, Use of chest CT in com- bination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion, Radiology (2020), https://doi.org/10.1148/radiol. 2020200330:200330. Referans4 Juanjuan Zhao, Quan Yuan, Haiyan Wang, Wei Liu, Xuejiao Liao, Yingying Su, Xin Wang, Jing Yuan, Tingdong Li, Jinxiu Li, Shen Qian, Congming Hong, Fuxiang Wang, Yingxia Liu, Zhaoqin Wang, Qing He, Zhiyong Li, Bin He, Tianying Zhang, Yang Fu, Shengxiang Ge, Lei Liu, Jun Zhang, Ningshao Xia, Zheng Zhang. Antibody responses to SARS-COV-2 in patients of novel coronavirus disease 2019. DOI: 10.1093/cid/ciaa344. Referans5 Wei-jie Guan, Zheng-yi Ni, Yu Hu, Wen-hua Liang, Chun-quan Ou, Jian-xing He, Lei Liu, Hong Shan, Chun-liang Lei, David S.C. Hui, Bin Du, Lan-juan Li, Guang Zeng, Kwok-Yung Yuen, Ru-chong Chen, Chun-li Tang, Tao Wang, Ping-yan Chen, Jie Xiang, Shi-yue Li, Jin-lin Wang, Zi-jing Liang, Yi-xiang Peng, Li Wei, Yong Liu, Ya-hua Hu, Peng Peng, Jian-ming Wang, Ji-yang Liu, Zhong Chen, Gang Li, Zhi-jian Zheng, Shao-qin Qiu, Jie Luo, Chang-jiang Ye, Shao-yong Zhu, Nan-shan Zhong. Clinical characteristics of 2019 novel coronavirus infection in China. N Engl J Med. DOI: 10.1056/NEJMoa2002032 Referans6 Ming Wang, Qing Wu, Wanzhou Xu, Bin Qiao, Jingwei Wang, Hongyun Zheng, Shupeng Jiang, Junchi Mei, Zegang Wu, Yayun Deng, Fangyuan Zhou, Wei Wu, Yan Zhang, Zhihua Lv, Jingtao Huang, Xiaoqian Guo, Lina Feng, Zunen Xia, Di Li, Zhiliang Xu, Tiangang Liu, Pingan Zhang, Yongqing Tong, Yan Li. Clinical Diagnosis of 8274 samples with 2019-novel coronavirus in Wuhan. medRxiv 2020; published online Feb 18. DOI:10.1101/2020.02.12.20022327. Referans7 Marie-Pierre Revel, Anagha P. Parkar, Helmut Prosch, Mario Silva, Nicola Sverzellati, Fergus Gleeson, Adrian Brady. European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI). Eur Radiol. 2020 Apr 20. doi: 10.1007/s00330-020-06865-y. Referans8 Luca Spiezia, Annalisa Boscolo, Francesco Poletto, Lorenzo Cerruti, Ivo Tiberio, Elena Campello, Paolo Navalesi, Paolo Simioni. COVID-19-Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure2020 Apr 21. doi: 10.1055/s-0040-1710018. Referans9 Chaolin Huang, Yeming Wang, Xingwang Li, Lili Ren, Jianping Zhao, Yi Hu, Li Zhang, Guohui Fan, Jiuyang Xu, Xiaoying Gu, Zhenshun Cheng, Ting Yu, Jiaan Xia, Yuan Wei, Wenjuan Wu, Xuelei Xie, Wen Yin, Hui Li, Min Liu, Yan Xiao, Hong Gao, Li Guo, Jungang Xie, Guangfa Wang, Rongmeng Jiang, Zhancheng Gao, Qi Jin, Jianwei Wang, Bin Cao. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet 395 (2020) 497–506.
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Case Reports
Authors

Cihan Yeşil 0000-0003-3558-5689

Burak Okyar 0000-0002-9028-9930

Publication Date July 21, 2020
Acceptance Date June 27, 2020
Published in Issue Year 2020Volume: 42 Issue: 2

Cite

AMA Yeşil C, Okyar B. 2 Kez Polymerase Chain Reaction (PCR) Testi negatif sonuçlanan Coronovirus Disease-19 (COVİD-19) şüpheli 3 hastada hızlı antikor testinin kullanımı: Olgu sunumu. CMJ. July 2020;42(2):208-212. doi:10.7197/cmj.vi.747330