Open AccessINCONSISTENCIES IN DETECTING RDRP GENE BY RDRP CONFIRMATORY ASSAY LEADING TO FALSE NEGATIVE COVID-19 RESULTS: A CASE REPORT FROM A DISTRICT REFERRAL HOSPITAL
Author(s) -
J. Y. Yong,
M Sinniah,
T. Joash,
Nurkhairany Amyra Mokhtar,
Marc Cheong
Publication year - 2020
Publication title -
journal of health and translational medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 7
eISSN - 2289-392X
pISSN - 1823-7339
DOI - 10.22452/jummec.sp2020no1.2
Subject(s) - virology , serology , gene , polymerase chain reaction , pneumonia , medicine , covid-19 , biology , immunology , disease , antibody , genetics , infectious disease (medical specialty)
Reverse transcriptase polymerase chain reaction (RT-PCR) assays for coronavirus disease 2019 (COVID-19) should be interpreted with clinical, epidemiological history and exposure risk to avoid misdiagnosis. We report a cruise-ship worker with significant travelling history, presented with acute respiratory symptoms and radiographic evidence of viral pneumonia. Initial RNA-dependent RNA polymerase (RdRp) gene confirmatory assay was negative. Use of a more robust RT-PCR assay detected ORF1ab, N and S genes for COVID-19, and the diagnosis was supported by an IgM and IgG positive COVID-19 serology. Subsequent follow up samples which reported inconsistencies in detecting RdRp gene also raise the concern of reliability of RdRp gene as the confirmatory assay for diagnosis of COVID-19. Patient later had prolonged viral shedding beyond serological recovery, with a negative viral culture reflecting non-infectivity.