Park Sung-Soo, Hong Duck-Jin, Gatchalian Katrine K, Oh Hye-Young
Division of Internal Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.
Department of Pulmonology, Seoul National University Hospital, Seoul, South Korea.
J Clin Virol Plus. 2022 Aug;2(3):100100. doi: 10.1016/j.jcvp.2022.100100. Epub 2022 Jul 23.
False-positive inconclusive polymerase chain reaction (PCR) results against severe acute respiratory syndrome coronavirus 2 were not low and have potentially harmful effects. We aimed to find parameters to differentiate positive cases from false-positive ones, and suggest an optimal scheme and follow-up period for inconclusive results.
Cases with inconclusive PCR tests among healthcare personnel from February 2020 to June 2021 were classified as confirmed positive, clinically positive, and clinically negative groups, which were compared. The diagnostic accuracy of follow-up tests and composites of clinical and laboratory data were analyzed.
Symptoms, contact history, and lower cycle threshold of the N gene were more common in the COVID-19 positive group. The scoring schemes combining symptom and contact history with follow-up PCR results had higher sensitivities than the PCR tests only modality. Follow-up tests up to 5 days combined with symptoms and contact history could discriminate between positive and negative cases.
A follow-up PCR test up to day 5 with clinical features might predict positivity and shorten the quarantine period in most healthcare personnel.
针对严重急性呼吸综合征冠状病毒2的聚合酶链反应（PCR）假阳性不确定结果并不少见，且可能产生有害影响。我们旨在寻找区分阳性病例与假阳性病例的参数，并为不确定结果提出最佳方案及随访期。
将2020年2月至2021年6月医护人员中PCR检测结果不确定的病例分为确诊阳性、临床阳性和临床阴性组，并进行比较。分析随访检测以及临床和实验室数据综合指标的诊断准确性。
COVID-19阳性组更常见出现症状、接触史以及N基因较低的循环阈值。将症状和接触史与随访PCR结果相结合的评分方案比仅采用PCR检测的方式具有更高的敏感性。长达5天的随访检测结合症状和接触史可区分阳性和阴性病例。
结合临床特征进行长达5天的随访PCR检测可能预测阳性情况，并缩短大多数医护人员的隔离期。
