Negative COVID-19 Test: What Next?
The COVID-19 pandemic is one of the most devastating tragedies of this century. Over the past few months, it affected almost all the countries in the world. There has been a change in the recommendations for testing the suspected COVID-19 patients and con
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Abstract
The COVID-19 pandemic is one of the most devastating tragedies of this century. Over the past few months, it affected almost all the countries in the world. There has been a change in the recommendations for testing the suspected COVID-19 patients and contacts from time to time, globally. The status of the test (positive or negative) has significant health implications. In this chapter, we discuss the implications of a negative result in COVID-19 test, its diagnostic, clinical, and psycho-social implications. Keywords
COVID-19 test · Negative test · Diagnosis · SARS-CoV-2
Authors Sarvodaya Tripathy, Sujita Kumar Kar, Shailendra K Saxena have equally contributed to this chapter as first author. S. Tripathy (*) Department of Microbiology, Maharaja Krishna Chandra Gajapati Medical College & Hospital, Brahmapur, Ganjam, Odisha, India S. M. Y. Arafat Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh S. K. Kar Department of Psychiatry, King George’s Medical University (KGMU), Lucknow, India S. K. Saxena Centre for Advanced Research (CFAR), Faculty of Medicine, King George’s Medical University (KGMU), Lucknow, India # The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2020 P. Chandra, S. Roy (eds.), Diagnostic Strategies for COVID-19 and other Coronaviruses, Medical Virology: From Pathogenesis to Disease Control, https://doi.org/10.1007/978-981-15-6006-4_10
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Introduction
In the latest situation report on COVID-19 by the World Health Organization (WHO), more than 3 million confirmed cases and 0.26 million deaths have been reported globally (World Health Organization 2020a). COVID-19 first appeared in Hubei Province, China in December 2019. A cluster of patients was admitted with fever and respiratory symptoms showing lung opacities in CT-scan and were initially diagnosed to have pneumonia. A negative multiplex real-time polymerase chain reaction (RT-PCR) of common respiratory pathogen panels further suggested pneumonia caused by an unknown etiological agent (Udugama et al. 2020; Mahapatra and Chandra 2020). Analysis of bronchoalveolar lavage (BAL) fluid revealed a pathogen with a similarity of the genetic sequence with earlier detected coronaviruses, severe acute respiratory syndrome virus (SARS-CoV) and Middle East respiratory syndrome virus (MERS-CoV). It, however, showed maximum genetic similarity with bat coronavirus RaTG13 (Zhou et al. 2020). First, the virus was detected in the bronchoalveolar lavage (BAL) fluid taken from patients in Wuhan, China. Then the virus was cultured in human respiratory epithelial cell culture, and the supernatant was analyzed (after making it non-infective) using transmission electron microscopy. Currently, the laboratory diagnosis of coronavirus disease 2019 (COVID-19) is mostly done using a nucleic acid amplification test (NAAT). Real-time reversetranscription polymerase chain reaction (rRT-PCR) is a recommended test (World Health Organization 2020b). It involv
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