Factors Contributing to False Negative Results when Performing Diagnostics of COVID-19 by Reverse Transcription-Polymerase Chain Reaction in Real Time
https://doi.org/10.35825/2587-5728-2022-6-1-56-65
EDN: jfxfwr
Abstract
Reverse transcription-real-time polymerase chain reaction (RT-PCR) is currently the leading laboratory diagnostic tool for COVID-19. With the help of RT-PCR-RT, diagnostics is carried out at the early stages of the development of the disease. The studied clinical samples, as a rule, are swabs from the pharynx and nasopharynx. The aim of the work is to identify and analyze the factors that contribute to false negative results when diagnosing COVID-19 by RT-PCR-RT. It is shown in the article, that the analytical sensitivity of the real-time RT-PCR method is not the main factor in assessing the possibility of obtaining false negative results. The paper considers the effect of drinking hot drinks (tea, coffee), alcohol and smoking (immediately before sampling) on the results of the analysis of swabs from the pharynx and nasopharynx by RT-PCR RT. It was found that the intake of hot drinks before sampling (the probability of obtaining a false negative result is at least 80%) influences most of all on the possibility of obtaining a false negative result in RT-PCR-RT in swabs from the pharynx. The use of small doses of alcohol (0.25–0.33 g of ethanol per 1 kg of body weight) has a lesser effect. Smoking immediately prior to sample collection does not lead to a false negative result in real-time RT-PCR. None of the considered influences affects the possibility of obtaining false negative results in the analysis of swabs from the nasopharynx. Recommendations were made on the need for simultaneous examination of both throat swabs and nasopharyngeal swabs in the ongoing diagnosis of COVID-19.
Keywords
About the Authors
A. A. PetrovRussian Federation
Chief of department, Doctor of Medical Sciences
141306, Sergiev Posad, Oktyabrskaya st., 11.
T. E. Sizikova
Russian Federation
Researcher, Candidate of Biologic Sciences
141306, Sergiev Posad, Oktyabrskaya st., 11.
N. V. Karulina
Russian Federation
Researcher, Candidate of Biologic Sciences
141306, Sergiev Posad, Oktyabrskaya st., 11.
O. V. Chuhralya
Russian Federation
Assistant of chief of department
141306, Sergiev Posad, Oktyabrskaya st., 11.
D. I. Paveliev
Russian Federation
Researcher
141306, Sergiev Posad, Oktyabrskaya st., 11.
N. A. Saifulina
Russian Federation
Junior Researcher
141306, Sergiev Posad, Oktyabrskaya st., 11.
A. V. Sapkulov
Russian Federation
Assistant of head of Federal State Budgetary Establishment «48 Central Scientific Research Institute» of the Ministry of the Defense of the Russian Federation
141306, Sergiev Posad, Oktyabrskaya st., 11.
V. N. Lebedev
Russian Federation
Leading researcher, Doctor of Biologic Sciences, Professor
141306, Sergiev Posad, Oktyabrskaya st., 11.
D. A. Kutaev
Russian Federation
Deputy head of Federal State Budgetary Establishment «48 Central Scientific Research Institute» of the Ministry of the Defense of the Russian Federation, Candidate of Medical Sciences
141306, Sergiev Posad, Oktyabrskaya st., 11.
S. V. Borisevich
Russian Federation
Head of Federal State Budgetary Establishment «48 Central Scientific Research Institute» of the Ministry of the Defense of the Russian Federation, Corresponding member of Russian Academy of Sciences, Doctor of Biologic Sciences, Professor.
141306, Sergiev Posad, Oktyabrskaya st., 11.
References
1. South A.M., Diz D.I., Chappell M.C. COVID-19, ACE2, and the cardiovascular consequences // Heart and Circulatory Physiology. 2020. V. 318. № 5. P. 1084–1090.
2. Grant M.C., Geoghegan L., Arbyn M. et al. The prevalence of symptoms in 24.410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): a systematic review and meta-analysis of 148 studies from 9 countries // PLOS ONE. 2020. V. 15. № 6. P. e0234765. https://doi.org/10.1371/journal.pone.0234765
3. CDC COVID-19 Response Team. SARS-CoV-2 B.1.1.529 (Omicron) Variant - United States, December 1-8, 2021. MMWR Morb Mortal Wkly Rep. 2021. V. 70. № 50. P. 1731–1734. https://doi.org/10.15585/mmwr.mm7050e1
4. Scribne H. Doctor reveals new nightly omicron variant symptom // Deseret News. Archived from the original on 2 January 2022.
5. Oran D., Topol E.J. Prevalence of asymptomatic SARS-CoV-2 infection: a narrative review // Ann. Int. Med. 2020. V. 173. P. 362–367. https://doi.org/10.7326/M20-3012 PMID 32491919
6. Arevalo-Rodriguez I., Buitrago-Garcia D., Simancas-Racines D. et al. False-negative results of initial RT-PCR assays for COVID-19: A systematic review // PLoS One. 2020. V. 15(12). https://doi.org/10.1371/journal.pone.0242958
7. Long C., Xu H., Shen Q. et al. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT? // Eur. J. Radiol. 2020. 108961. https://doi.org/10.1016/j.ejrad.2020.108961
8. Pecoraro V., Negro A., Pirotti T., Trenti T. Estimate false-negative RT-PCR rates for SARS-CoV-2. A systematic review and meta-analysis // Eur. J. Clin. Invest. 2022. V. 52(2). https://doi.org/10.1111/eci.13706
9. Kanji J.N., Zelyas N., MacDonald C. et al. False negative rate of COVID-19 PCR testing: a discordant testing analysis // Virol. J. 2021. V. 18(1). https://doi.org/10.1186/s12985-021-01489-0
10. Alsharif W., Qurashi A. Effectiveness of COVID-19 diagnosis and management tools: A review. Radiography (Lond) // 2021. V. 27(2). P. 682–687. https://doi.org/10.1016/j.radi.2020.09.010
11. Tan W., Aboulhosn J. The cardiovascular burden of coronavirus disease 2019 (COVID-19) with a focus on congenital heart disease // Int. J. Cardiol. 2020. V. 309. P. 70–77. https://doi.org/10.1016/j.ijcard.2020.03.063
12. Bai Y., Yao L., Wei T., Tian F., Jin D.Y., Chen L. et al. Presumed asymptomatic carrier transmission of COVID-19 // JAMA. 2020. V. 323. № 14. Р. 1406–1407. https://doi.org/10.1001/jama.2020.2565
13. Mizumoto K., Kagaya K., Zarebski A., et al. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020 // Euro Surveill. 2020. V. 25. № 10. P. 2000180. https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000180
14. Masters P.S. The molecular biology of coronaviruses // Adv. Virus. Res. 2006. V. 66. P. 193–292. https://doi.org/10.1016/S0065-3527(06)66005-3
15. Patent RU № 2732608 (2020). (in Russian).
16. Genes V.S. Some simple methods of cybernetic data processing of diagnostic and physiological studies. Moscow: Nauka, 1967. (in Russian).
Review
For citations:
Petrov A.A., Sizikova T.E., Karulina N.V., Chuhralya O.V., Paveliev D.I., Saifulina N.A., Sapkulov A.V., Lebedev V.N., Kutaev D.A., Borisevich S.V. Factors Contributing to False Negative Results when Performing Diagnostics of COVID-19 by Reverse Transcription-Polymerase Chain Reaction in Real Time. Journal of NBC Protection Corps. 2022;6(1):56-65. (In Russ.) https://doi.org/10.35825/2587-5728-2022-6-1-56-65. EDN: jfxfwr