• Yan Rong, Fei Wang, Jing Liu, Yang Zhou, Xiaoli Li, Xinhua Liang, Dandan Zhang, Huadong Zeng, Jing Wang, and Yi Shi.
• Department of Respiratory and Critical Care Medicine, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China.
• J. Med. Virol. 2021 Jan 1; 93 (1): 448-455.

AbstractThis study investigates the clinical and imaging characteristics of coronavirus disease 2019 (COVID-19) patients with false-negative nucleic acids. Mild-to-moderate COVID-19 patients, including 19 cases of nucleic acid false-negative patients and 31 cases of nucleic acid positive patients, were enrolled. Their epidemiological, clinical, and laboratory examination data and imaging characteristics were analyzed. Risk factors for false negatives were discussed. Compared with the nucleic acid positive group, the false-negative group had less epidemiological exposure (52.6% vs 83.9%; P  = .025), less chest discomfort (5.3% vs 32.3%; P  = .035), and faster recovery (10 [8, 13] vs 15 [11, 18.5] days; P  = .005). The number of involved lung lobes was (2 [1, 2.5] vs 3 [2, 4] days; P  = .004), and the lung damage severity score was (3 [2.5, 4.5] vs 5 [4, 9] days; P  = .007), which was lighter in the nucleic acid false-negative group. Thus, the absence of epidemiological exposure may be a potential risk factor for false-negative nucleic acids. The false-negative cases of COVID-19 are worth noting because they have a risk of viral transmission without positive test results, lighter clinical manifestations, and less history of epidemiological exposure.© 2020 Wiley Periodicals LLC.

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