Kokkinakis Ioannis, Selby Kevin, Favrat Bernard, Genton Blaise, Cornuz Jacques
Unisanté, Centre universitaire de médecine générale et de santé publique, Rue du Bugnon 44, 1011 Lausanne.
Rev Med Suisse. 2020 Apr 8;16(689):699-701.
The Covid-19 pandemic imposes new diagnostic strategies in order to optimize the medical care of our patients. The current biblio-graphy, although of low quality, shows a sensitivity of 56 to 83 % for the Covid-19 PCR. Even though one negative test can exclude a Covid-19 in the majority of cases, the NPV (Negative Predictive Value) decreases with increasing prevalence (pre-test probability). This finding suggests the need for strict auto-isolation of patients until the resolution of their symptoms. For patients that present with typical symptoms, who have a presumed Covid-19 prevalence of -40-50 %, a negative test should be interpreted with caution and a repeat test may be needed.
新冠疫情促使采用新的诊断策略，以优化对患者的医疗护理。当前的文献资料，尽管质量不高，但显示新冠病毒PCR检测的敏感性为56%至83%。尽管一次阴性检测在大多数情况下可以排除新冠病毒感染，但阴性预测值（NPV）会随着患病率（检测前概率）的增加而降低。这一发现表明，在症状缓解之前，需要对患者进行严格的自我隔离。对于出现典型症状、假定新冠病毒患病率为40%-50%的患者，阴性检测结果应谨慎解读，可能需要再次检测。
