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Williams, Thomas C.; Wastnedge, Elizabeth; McAllister, Gina; Bhatia, Ramya; Cuschieri, Kate; Kefala, Kallirroi; Hamilton, Fiona; Johannessen, Ingólfur; Laurenson, Ian F.; Shepherd, Jill; Stewart, Alistair; Waters, Donald; Wise, Helen; Templeton, Kate E.

Sensitivity of RT-PCR testing of upper respiratory tract samples for SARS-CoV-2 in hospitalised patients: a retrospective cohort study

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  • Medientyp: E-Artikel
  • Titel: Sensitivity of RT-PCR testing of upper respiratory tract samples for SARS-CoV-2 in hospitalised patients: a retrospective cohort study
  • Beteiligte: Williams, Thomas C.; Wastnedge, Elizabeth; McAllister, Gina; Bhatia, Ramya; Cuschieri, Kate; Kefala, Kallirroi; Hamilton, Fiona; Johannessen, Ingólfur; Laurenson, Ian F.; Shepherd, Jill; Stewart, Alistair; Waters, Donald; Wise, Helen; Templeton, Kate E.
  • Erschienen: F1000 Research Ltd, 2020
  • Erschienen in: Wellcome Open Research, 5 (2020), Seite 254
  • Sprache: Englisch
  • DOI: 10.12688/wellcomeopenres.16342.1
  • ISSN: 2398-502X
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: Background: This study aimed to determine the sensitivity and specificity of reverse transcription PCR (RT-PCR) testing of upper respiratory tract (URT) samples from hospitalised patients with coronavirus disease 2019 (COVID-19), compared to the gold standard of a clinical diagnosis. Methods: All URT RT-PCR testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in NHS Lothian, Scotland, United Kingdom between the 7th of February and 19th April 2020 (inclusive) was reviewed, and hospitalised patients were identified. All URT RT-PCR tests were analysed for each patient to determine the sequence of negative and positive results. For those who were tested twice or more but never received a positive result, case records were reviewed, and a clinical diagnosis of COVID-19 allocated based on clinical features, discharge diagnosis, and radiology and haematology results. For those who had a negative RT-PCR test but a clinical diagnosis of COVID-19, respiratory samples were retested using a multiplex respiratory panel, a second SARS-CoV-2 RT-PCR assay, and a human RNase P control. Results: Compared to the gold standard of a clinical diagnosis of COVID-19, the sensitivity of a single upper respiratory tract RT-PCR for COVID-19 was 82.2% (95% confidence interval 79.0-85.1%).   The sensitivity of two upper respiratory tract RT-PCR tests increased sensitivity to 90.6% (CI 88.0-92.7%). A further 2.2% and 0.9% of patients who received a clinical diagnosis of COVID-19 were positive on a third and fourth test; this may be an underestimate of the value of further testing as the majority of patients 93.0% (2999/3226) only had one or two URT RT-PCR tests. Conclusions: The sensitivity of a single RT-PCR test of URT samples in hospitalised patients is 82.2%. Sensitivity increases to 90.6% when patients are tested twice.  A proportion of cases with clinically defined COVID-19 never test positive on URT RT-PCR despite repeat testing.
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