Ferrari Davide, Sabetta Eleonora, Ceriotti Daniele, Motta Andrea, Strollo Marta, Banfi Giuseppe, Locatelli Massimo
SCVSA Department, University of Parma, Parma, Italy; 2 Laboratory Medicine Service, San Raffaele Hospital, Milano, Italy; 3 Vita-Salute University, San Raffaele, Milano, Italy; IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.
San Raffaele Hospital.
Acta Biomed. 2020 Sep 7;91(3):e2020003. doi: 10.23750/abm.v91i3.9843.
The COVID-19 outbreak is now a pandemic disease reaching as much as 210 countries worldwide with more than 2.5 million infected people and nearly 200.000 deaths. Amplification of viral RNA by RT-PCR represents the gold standard for confirmation of infection, yet it showed false-negative rates as large as 15-20% which may jeopardize the effect of the restrictive measures taken by governments. We previously showed that several hematological parameters were significantly different between COVID-19 positive and negative patients. Among them aspartate aminotransferase and lactate dehydrogenase had predictive values as large as 90%. Thus a combination of RT-PCR and blood tests could reduce the false-negative rate of the genetic test.
We retrospectively analyzed 24 patients showing multiple and inconsistent RT-PCR, test during their first hospitalization period, and compared the genetic tests results with their AST and LDH levels.
We showed that when considering the hematological parameters, the RT-PCR false-negative rates were reduced by almost 4-fold.
The study represents a preliminary work aiming at the development of strategies that, by combining RT-PCR tests with routine blood tests, will lower or even abolish the rate of RT-PCR false-negative results and thus will identify, with high accuracy, patients infected by COVID-19.
新型冠状病毒肺炎(COVID-19)疫情现已成为一种大流行病,波及全球多达210个国家,感染人数超过250万,死亡人数近20万。通过逆转录聚合酶链反应(RT-PCR)扩增病毒RNA是确认感染的金标准,但它显示出高达15%-20%的假阴性率,这可能会危及政府采取的限制措施的效果。我们之前表明,COVID-19阳性和阴性患者之间的几个血液学参数存在显著差异。其中,天冬氨酸转氨酶和乳酸脱氢酶的预测价值高达90%。因此,RT-PCR和血液检测相结合可以降低基因检测的假阴性率。
我们回顾性分析了24例在首次住院期间RT-PCR检测结果多次不一致的患者,并将基因检测结果与其天门冬氨酸氨基转移酶(AST)和乳酸脱氢酶(LDH)水平进行了比较。
我们发现,考虑血液学参数时,RT-PCR的假阴性率降低了近4倍。
本研究是一项初步工作,旨在制定策略,通过将RT-PCR检测与常规血液检测相结合,降低甚至消除RT-PCR假阴性结果的发生率,从而高精度地识别COVID-19感染患者。