Baicry Florent, Le Borgne Pierrick, Fabacher Thibaut, Behr Martin, Lemaitre Elena Laura, Gayol Paul-Albert, Harscoat Sébastien, Issur Nirvan, Garnier-Kepka Sabrina, Ohana Mickael, Bilbault Pascal, Oberlin Mathieu
Emergency Department, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS), University of Strasbourg, 67000 Strasbourg, France.
J Clin Med. 2020 Sep 18;9(9):3014. doi: 10.3390/jcm9093014.
The sensitivity of reverse transcriptase polymerase chain reaction (RT-PCR) has been questioned due to negative results in some patients who were strongly suspected of having coronavirus disease 2019 (COVID-19). The aim of our study was to analyze the prognosis of infected patients with initial negative RT-PCR in the emergency department (ED) during the COVID-19 outbreak. This study included two cohorts of adult inpatients admitted into the ED. All patients who were suspected to be infected with SARS-CoV-2 and who underwent a typical chest CT imaging were included. Thus, we studied two distinct cohorts: patients with positive RT-PCR (PCR+) and those with negative initial RT-PCR (PCR-). The data were analyzed using Bayesian methods. We included 66 patients in the PCR- group and 198 in the PCR+ group. The baseline characteristics did not differ except in terms of a proportion of lower chronic respiratory disease in the PCR- group. We noted a less severe clinical presentation in the PCR- group (lower respiratory rate, lower oxygen need and mechanical ventilation requirement). Hospital mortality (9.1% vs. 9.6%) did not differ between the two groups. Despite an initially less serious clinical presentation, the mortality of patients infected by SARS-CoV-2 with a negative RT-PCR did not differ from those with positive RT-PCR.
由于一些被高度怀疑患有2019冠状病毒病（COVID-19）的患者的逆转录聚合酶链反应（RT-PCR）结果为阴性，其敏感性受到质疑。我们研究的目的是分析在COVID-19疫情期间急诊科（ED）中初始RT-PCR结果为阴性的感染患者的预后。本研究纳入了两组入住急诊科的成年住院患者。纳入所有疑似感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）且接受了典型胸部CT成像的患者。因此，我们研究了两个不同的队列：RT-PCR结果为阳性的患者（PCR+）和初始RT-PCR结果为阴性的患者（PCR-）。使用贝叶斯方法对数据进行分析。PCR-组纳入了66例患者，PCR+组纳入了198例患者。除了PCR-组中慢性下呼吸道疾病的比例较低外，两组的基线特征没有差异。我们注意到PCR-组的临床表现较轻（呼吸频率较低、氧气需求较低和机械通气需求较低）。两组的医院死亡率（9.1%对9.6%）没有差异。尽管初始临床表现较轻，但RT-PCR结果为阴性的SARS-CoV-2感染患者的死亡率与RT-PCR结果为阳性的患者没有差异。
