10 days ago, we received a referral of a 65 year old male with complains of fever, cough and progressive dyspnea with no known co-morbidities. On further questioning, we exttacted a history that the patient has a close contact with a relative who went to a 6-Cock Derby held in Matina Davao. With this history, together with patient’s signs and symptoms, we admitted the patient in our institution and got some laboratories and sent the swab specimen to SPMC. And while awaiting the results, we managed the patient as Acute Respiratory Distress Syndrome (ARDS) due to Pneumonia. Three (3) days after, the result showed “Negative” for SARSCOV-2 VIRUS. However, putting together patient’s history with his signs and symptoms and the patient’s chest x-ray and laboratory shows otherwise. That is why I requested for a repeat swab to confirm my strong suspicion of COVID Disease. Currently, the patient’s condition is still guarded with oxygen support but with signs of clinical improvement.
There are a lot of factors why these things can happen, meaning the initial test was negative and then turned out to be positive. First is the procedure and specimen collection itself. In this case, it was addressed by getting a total of four (4) specimens: one Nasopharyngeal and one Oropharyngeal twenty four (24) hours apart. Second, it could be the test itself. Since we all know that the RT-qPCR’s sensitivity and specificity is not 100%. Meaning, it could result to False Negative or False Positive results. That is why clinicians judgement taking into account the patient’s history, signs and symptoms and other supportive laboratory test specially Chest X-ray and Inflammatory markers is used to make a good decision.. (Ma. Cecilia P. Bayana, CRH)