Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Av. Javier Mina 301, Col. Centro, C.P. 28000, Colima, Colima, Mexico; Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Col. Las Víboras, C.P. 28040, Colima, Colima, Mexico.
Facultad de Ingeniería Civil, Universidad de Colima, km. 9 carretera Colima-Coquimatlán, C.P. 28400, Coquimatlán, Colima, Mexico.
Public Health. 2021 Jun;195:123-125. doi: 10.1016/j.puhe.2021.04.023. Epub 2021 May 5.
The objective of this study was to evaluate the survival experience of suspicion COVID-19 hospitalized patients with pneumonia and negative baseline reverse-transcription quantitative polymerase chain reaction (RT-qPCR) test results.
We conducted a nationwide retrospective cohort study in Mexico.
Adult pneumonia inpatients fulfilling suspected COVID-19 criteria, and hospital entry from March to August 2020, were enrolled. The Kaplan-Meier method was to use to compare survival estimates among patients with negative RT-qPCR nasopharyngeal or oropharyngeal swabs and those with a baseline positive test.
Data from 64,624 individuals fulfilling suspected COVID-19 criteria were analyzed and 1.6% of them had negative RT-qPCR tests. The overall mortality rate was higher among laboratory-positive patients (48.5% vs. 34.2%, P < 0.001) and, at any given threshold, the survival estimates were higher among RT-qPCR-negative pneumonia inpatients.
The pathogenic mechanism of COVID-19 remains poorly understood and suspected cases with pneumonia and negative laboratory results represent a major challenge for healthcare systems. Our findings suggest that RT-qPCR-negative inpatients may have an improved disease prognosis, but the in-hospital mortality was still high among them. However, further research is needed to clarify the clinical and epidemiological implications of our results.
本研究旨在评估基线反转录定量聚合酶链反应（RT-qPCR）检测结果为阴性的疑似 COVID-19 肺炎住院患者的生存情况。
我们在墨西哥进行了一项全国性回顾性队列研究。
纳入 2020 年 3 月至 8 月符合疑似 COVID-19 标准且入院时患有肺炎的成年患者。采用 Kaplan-Meier 法比较鼻咽或口咽拭子 RT-qPCR 检测结果为阴性和基线阳性患者的生存估计值。
对满足疑似 COVID-19 标准的 64624 人进行了数据分析，其中 1.6%的患者 RT-qPCR 检测结果为阴性。实验室阳性患者的总体死亡率较高（48.5%比 34.2%，P<0.001），且在任何给定的阈值下，RT-qPCR 阴性肺炎住院患者的生存估计值更高。
COVID-19 的发病机制仍不清楚，疑似肺炎且实验室结果为阴性的病例对医疗系统构成了重大挑战。我们的研究结果表明，RT-qPCR 阴性的住院患者可能具有更好的疾病预后，但他们的住院死亡率仍然很高。然而，需要进一步的研究来阐明我们研究结果的临床和流行病学意义。
