Clinical, laboratory and high‑resolution computed tomography (HRCT) thorax profile of reverse transcription polymerase chain reaction (RT‑PCR) negative COVID‑19 suspects with moderate to severe disease

Diagnostic dilemma arises when patients with clinical suspicion of COVID‑19 disease having moderate‑to‑severe respiratory symptoms yield negative result for COVID‑19 in reverse transcription polymerase chain reaction (RT‑PCR). This study evaluated the clinical, laboratory and HRCT thorax findings among RT‑PCR‑negative COVID‑19 suspects with moderate‑to‑severe disease.

A hospital‑based retrospective observational study was conducted between July 2021 to December 2021, among 60 moderate and severe symptomatic COVID‑19 suspects admitted in the severe acute respiratory illness (SARI) ward and intensive care unit (ICU), who were negative for COVID‑19 in RT‑PCR. Data were abstracted from the medical records section of the hospital using a predesigned data abstraction form and presented by descriptive statistics.

Mean age of study participants was 55.5 years (SD 14.1 years), and majority were males (n = 43, 71.7%). Common presenting symptoms were fever (n = 60, 100%), dyspnea (n = 57, 95%), and cough (n = 54, 90%). The common laboratory findings were rise of C‑reactive protein (n = 60, 100%), NLR (n = 49, 81.7%), d‑dimer (n = 47, 78.3%), ferritin (n = 46, 76.7%), and LDH (n = 40, 66.7%). HRCT scan of thorax revealed ground glass opacities with or without consolidations located bilaterally with diffuse or peripheral distribution, interlobar septal thickening (n = 43, 74.1%), vascular thickening (n = 35, ≥58.3%), and sub‑pleural lines (n = 32, 53.3%). Median CT‑SS value was 15 (IQR 11–19), and majority (n = 56, 93.3%) belonged to CO‑RADS ≥4.

Diagnosis of COVID‑19 can be presumed in RT‑PCR‑negative suspected COVID‑19 patients with moderate‑to‑severe disease, with marked rise of inflammatory markers and HRCT revealing typical findings of COVID‑19 pneumonia.