DEMOGRAPHIC AND CLINICAL OUTCOMES IN COVID-19 PATIENTS WITH POSITIVE AND NEGATIVE RT-PCR TEST

ABSTRACT:

BACKGROUND: During the COVID 19 pandemic, many patients had respiratory symptoms such as cough, fever, shortness of breath etc. suggestive of SARS virus, but had a negative by nasal swab RTPCR. This study is carried to compare the clinical features, inflammatory markers, HRCT thorax and prognosis between RT-PCR positive and negative patients. MATERIAL AND METHODS: This is a retrospective study of RTPCR positive patients and patients with clinical diagnosis of COVID-19 [Suspects] i.e., RTPCR negative. We compared the clinical findings and outcomes of PCR-positive patients with those of PCR-negative patients. A total of 56 RTPCR positive and 28 RTPCR negative patients were taken for the study.  RESULTS: The RTPCR negative group were younger (52.1 ± 12.2 vs 58.5±15.3, p=0.03) but were similar to RTPCR positive patients in terms of demographics, comorbidities, and presenting symptoms. RTPCR negative had higher lymphocyte counts (1819±868 Vs 1331±737 ,p=0.01)and less severe elevation of serum CRP values(48mg/dl) (28.57% vs50%,p=0.03).HRCT severity were also less severe in RTPCR negative group (10.7% vs 28.57% p=0.006). Also clinical outcomes regarding ICU admission (25% vs 46.42% p=0.02), Invasive ventilator support(21.4% vs 39.65% p=0.03) and length of hospital stay were also less (9±4 vs 14±9 p=<0.001) as compared to RTPCR positive patients. CONCLUSION: This study finds that one third of COVID 19 patients were RTPCR negative and were diagnosed based on clinical and radiological findings. These patients had a more favorable clinical course, shorter hospital stay and less frequent admission to the intensive care unit.

KEYWORDS: SARS-CoV-2; RT-PCR; COVID-19; Respiratory infection; hospital mortality; Clinical symptoms.