INCONSISTENCIES IN DETECTING RDRP GENE BY RDRP CONFIRMATORY ASSAY LEADING TO FALSE NEGATIVE COVID-19 RESULTS: A CASE REPORT FROM A DISTRICT REFERRAL HOSPITAL
https://doi.org/10.22452/jummec.sp2020no1.2
- Author:
Jo Yen Yong
1
;
Mangalam Sinniah
2
;
Joash Tan-Loh
1
;
Nor Akmal Mokhtar
3
;
Brian Mun Keong Cheong
1
Author Information
1. Department of Medicine, Hospital Teluk Intan, Perak, Malaysia.
2. Clinipath Malaysia Sdn. Bhd., Selangor, Malaysia.
3. Department of Microbiology, Hospital Teluk Intan, Perak, Malaysia.
- Publication Type:Journal Article
- Keywords:
SARS-CoV-2;
COVID-19;
RT-PCR;
False Negative;
Prolonged Viral Shedding
- MeSH:
SARS-CoV-2;
COVID-19;
Reverse Transcriptase Polymerase Chain Reaction;
- From:Journal of University of Malaya Medical Centre
2020;23(Special Issue COVID19):1-5
- CountryMalaysia
- Language:English
-
Abstract:
Reverse transcriptase polymerase chain reaction (RT-PCR) assays for coronavirus disease 2019 (COVID-19) should be interpreted with clinical, epidemiological history and exposure risk to avoid misdiagnosis. We report a cruise-ship worker with significant travelling history, presented with acute respiratory symptoms and radiographic evidence of viral pneumonia. Initial RNA-dependent RNA polymerase (RdRp) gene confirmatory assay was negative. Use of a more robust RT-PCR assay detected ORF1ab, N and S genes for COVID-19, and the diagnosis was supported by an IgM and IgG positive COVID-19 serology. Subsequent follow up samples which reported inconsistencies in detecting RdRp gene also raise the concern of reliability of RdRp gene as the confirmatory assay for diagnosis of COVID-19. Patient later had prolonged viral shedding beyond serological recovery, with a negative viral culture reflecting non-infectivity.
- Full text:202508120956453386662259.pdf
