A patient with human coronavirus NL63 falsely diagnosed with COVID-19; Lesson learned for the importance of definitive diagnosis.

Published on May 9, 2021in Journal of Infection and Chemotherapy1.722
· DOI :10.1016/J.JIAC.2021.05.001
Yuki Otsuka1
Estimated H-index: 1
(Okayama University),
Hideharu Hagiya14
Estimated H-index: 14
(Okayama University)
+ 6 AuthorsFumio Otsuka35
Estimated H-index: 35
(Okayama University)
Sources
Abstract
The gold standard for the diagnosis of coronavirus disease 2019 (COVID-19) is a nucleic acid detection test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may occasionally reveal false-positive or false-negative results. Herein, we describe a case of a patient infected with human coronavirus NL63 (HCoV-NL63) who was falsely diagnosed with COVID-19 using the Ampdirect™ 2019-nCoV detection kit (Shimadzu Corporation, Japan) and SARS-CoV-2 Detection Kit (TOYOBO co., ltd.), and was admitted to a COVID-19 hospital ward. We suspected a cross-reaction between HCoV-NL63 and SARS-CoV-2; however, the reported genome sequences of HCoV-NL63 and N1/N2 primers for SARS-CoV-2 do not correspond. Thus, the PCR result was supposed to be a false positive possibly due to contamination or human error. Although the issue of a false-negative result has been the focus of much attention to prevent the spread of the disease, a false positive is fraught with problems as well. Physicians should recognize that unnecessary isolation violates human rights and a careful diagnosis is indispensable when the results of laboratory testing for COVID-19 are unclear. Generally, in cases such as a duplicate PCR test was partially positive, either N1 or N2 alone was positive, PCR testing for two or more target regions resulted in a positive only for single region, a high cycle threshold >35 was obtained, a false positive should be suspected. Especially, when these conditions coincide, we should recognize the high likelihood of a false positive.
📖 Papers frequently viewed together
1 Citations
12 Citations
References6
Newest
#1Brendan Healy (Cardiff University)H-Index: 10
#2Azizah Khan (Cardiff University)H-Index: 1
Last. Hibo AsadH-Index: 2
view all 5 authors...
False negative results in COVID-19 testing are well recognised and frequently discussed. False positive results, while less common and less frequently discussed, still have several adverse implications, including potential exposure of a non-infected person to the virus in a cohorted area. Although false positive results are proportionally greater in low prevalence settings, the consequences are significant at all times and potentially of greater significance in high-prevalence settings. We evalu...
1 CitationsSource
#1Ingrid Arevalo-Rodriguez (Ciber)H-Index: 15
#2Diana Buitrago-Garcia (University of Bern)H-Index: 4
Last. Javier Zamora (University of Birmingham)H-Index: 1
view all 13 authors...
BACKGROUND A false-negative case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is defined as a person with suspected infection and an initial negative result by reverse transcription-polymerase chain reaction (RT-PCR) test, with a positive result on a subsequent test. False-negative cases have important implications for isolation and risk of transmission of infected people and for the management of coronavirus disease 2019 (COVID-19). We aimed to review and critically...
88 CitationsSource
#1Elena Surkova (National Health Service)H-Index: 1
Last. Francis DrobniewskiH-Index: 79
view all 3 authors...
70 CitationsSource
#1Francesca Falasca (Policlinico Umberto I)H-Index: 1
#2Ilaria Sciandra (Policlinico Umberto I)
Last. Ombretta Turriziani (Sapienza University of Rome)H-Index: 27
view all 7 authors...
Abstract Background The detection of a low amount of viral RNA is crucial to identify a SARS-CoV-2 positive individual harboring a low level of virus, especially during the convalescent period. However, the detection of one gene at high Cycle threshold (Ct) has to be interpreted with caution. In this study we address this specific issue and report our real-life experience. Study design A total of 1639 nasopharyngeal swabs (NPS) were analyzed with Xpert® Xpress SARS-CoV-2. Positive samples showin...
2 CitationsSource
#1Kemmian D Johnson (LSU Health Sciences Center New Orleans)H-Index: 2
#1Kemmian D. Johnson (LSU Health Sciences Center New Orleans)H-Index: 3
Last. Abhilash Perisetti (University of Arkansas for Medical Sciences)H-Index: 12
view all 6 authors...
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been recently identified as the culprit of the highly infectious, outbreak named coronavirus disease 2019 (COVID-19) in China. Now declared a public health emergency, this pandemic is present in more than 200 countries with over 14 million cases and 600,000 deaths as of July 18, 2020. Primarily transmitted through the respiratory tract, the most common clinical presentations of symptomatic individuals infected with SARS-CoV-2 i...
26 CitationsSource
#1Jessica Watson (UoB: University of Bristol)H-Index: 13
#2Penny Whiting (UoB: University of Bristol)H-Index: 53
Last. John E. Brush (EVMS: Eastern Virginia Medical School)H-Index: 20
view all 3 authors...
### What you need to know Across the world there is a clamour for covid-19 testing, with Tedros Adhanom Ghebreyesus, director general of the World Health Organization, encouraging countries to “test, test, test.”1 The availability of the complete genome of covid-19 early in the epidemic facilitated development of tests to detect viral RNA.2 Multiple assays with different gene targets have been developed using reverse transcriptase polymerase chain reaction (RT-PCR).3 These viral RNA tests use sa...
286 CitationsSource
Cited By0
Newest