Trisnawati Ika, El Khair Riat, Puspitarani Dyah Ayu, Fauzi Aditya Rifqi
Pulmonology Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
Ann Med Surg (Lond). 2020 Nov;59:224-228. doi: 10.1016/j.amsu.2020.09.040. Epub 2020 Oct 6.
Prolonged nucleic acid conversion and false-negative real-time polymerase chain reaction (RT-PCR) results might occur in COVID-19 patients rather than infection recurrence.
We reported four cases who had negative RT-PCR results, in addition to the last two consecutive negative results. Patient-1 had negative RT-PCR results twice (the 6th and 8th) from a total of 11 swabs. Patient-2 had negative RT-PCR results once (the 5th) from a total of 8 swabs. Patient-3 showed negative results of RT-PCR twice (the 4th and 6th) from a total of 11 swabs. Patient-4 had negative RT-PCR results twice (the 2nd and 10th) from a total of 14 swabs.
The fluctuating trend of our RT-PCR results in our cases might be due to insufficient viral material in the specimen, laboratory errors during sampling, restrictions on sample transportation, or mutations in the primary and probe target regions in the SARS-CoV-2 genome. Several factors might affect the occurrence of prolonged nucleic acid conversion, including older age, comorbidities, such as diabetes and hypertension, and impaired immune function.
Here, we confirmed the occurrence of prolonged nucleic acid conversion and the possibility of false negative RT-PCR results in COVID-19 patients.
新型冠状病毒肺炎（COVID-19）患者可能会出现核酸转化时间延长和实时聚合酶链反应（RT-PCR）结果呈假阴性的情况，而非感染复发。
我们报告了4例患者，其RT-PCR结果呈阴性，且最后两次连续检测结果均为阴性。患者1共进行了11次拭子检测，其中两次（第6次和第8次）RT-PCR结果为阴性。患者2共进行了8次拭子检测，其中一次（第5次）RT-PCR结果为阴性。患者3共进行了11次拭子检测，其中两次（第4次和第6次）RT-PCR结果为阴性。患者4共进行了14次拭子检测，其中两次（第2次和第10次）RT-PCR结果为阴性。
我们所报告病例的RT-PCR结果出现波动趋势，可能是由于样本中病毒物质不足、采样过程中的实验室误差、样本运输限制或严重急性呼吸综合征冠状病毒2（SARS-CoV-2）基因组中引物和探针靶区域的突变。几个因素可能会影响核酸转化时间延长的发生，包括老年、合并症（如糖尿病和高血压）以及免疫功能受损。
在此，我们证实了COVID-19患者存在核酸转化时间延长的情况以及RT-PCR结果出现假阴性的可能性。
