Patient with false negative RT-PCR for COVID-19 referred to cancer hospital for lung cancer screening: A case report

Background: Even though RT-PCR tests are generally considered the gold standard for diagnosing SARS-CoV-2, they are not without flaws, and the likelihood of detecting an infection varies depending on when the test is performed. There is chance of false negative due to different pitfalls. So there is essential of correlation of radiological characteristics, abnormalities in biochemical tests and symptoms of suspected patient during COVID-19 epidemic. Case presentation: Herein, we report a 42-year-old male patient with high-grade fever, dry cough, headache and dizziness. He went for the RT-PCR test two times and reported negative. On the chest X-Ray, there was opacity on both lungs and referred to cancer-hospital for lung-cancer screening. The patient underwent chest-HRCT and laboratory tests for further evaluation and was identified as typical COVID-19 findings. Then the patient was isolated and treatment of given according to COVID-19 treatment guidelines Conclusion: It is concluded that a clinically symptomatic patient with typical chest HRCT and abnormal lab findings for COVID-19 should be considered as a COVID-19 patient and isolated even with two negative RT-PCR tests.

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Patient with False Negative RT-PCR for COVID-19 referred to Cancer Hospital for Lung Cancer Screening

Nepalese Journal of Cancer ◽

10.3126/njc.v5i1.41361 ◽

2021 ◽

Vol 5 (1) ◽

pp. 24-26

Author(s):

Ajay Kumar Yadav ◽

Suman Gnawali ◽

Sandip Kumar Mandal ◽

Gyan Bahadur Shrestha ◽

Gangbiao Yuan

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Treatment Guidelines ◽

False Negative ◽

Lung Cancer Screening ◽

Second Phase ◽

Rt Pcr ◽

Cancer Hospital ◽

Biochemical Laboratory ◽

Pcr Test

Background: To describe the characteristics and outcomes of patients with a clinical diagnosis of COVID-19 and false-negative SARS-CoV-2 reverse transcription-PCR (RT-PCR), and develop and internally validate a diagnostic risk score to predict risk of COVID-19 (including RT-PCR-negative COVID-19) among medical treatment. Case presentation: Herein, we report a 42-year-old male patient from myagdi district Nepal presenting with high grade fever, dry cough, headache and dizziness on the August 10, 2021 during second phase of COVID-19 pandemic. There is no history of hypertension and diabetes. He went for RT-PCR test at local COVID-19 screening center and reported as negative for RT-PCR test. After that he referred to Lumbini Zonal hospital for further evaluation. RT-PCT swab test was performed again and reported negative. On the chest X-Ray, there was opacity on both lungs and the patient was referred to cancer hospital for lung cancer screening. The patient underwent for HRCT chest and biochemical laboratory tests for further evaluation. The chest High Resolution Computed Tomography (HRCT) indicated ground grass opacity (GGO) with crazy paving a typical COVID-19 interstitial pneumonia. In the biochemical laboratory test, there were elevation in Leukocyte (Total WBC count), Neutrophil, Glucose, Bilirubin Direct, Bilirubin Total, SGOT/AST, SGPT/ALT and Lactate Dehydrogenase (LDH). There was low count found in Lymphocyte, Eosinophil and Monocyte. These laboratory parameters findings are typical sign of COVID-19 patients. Then patient was isolated and treatment of given according to COVID-19 treatment guidelines. On September 12, 2021, all diagnostic tests showed that patient recovered from COVID-19. Conclusion: It is safe to suggest that a symptomatic patient with typical chest HRCT and lab findings for COVID-19 should be quarantined or isolated even with 2 negative RT-PCR tests.

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False-Negative Results in Lung Cancer Screening—Evidence and Controversies

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2021.01.1607 ◽

2021 ◽

Author(s):

Emily C. Bartlett ◽

Mario Silva ◽

Matthew E. Callister ◽

Anand Devaraj

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

False Negative ◽

Lung Cancer Screening ◽

Negative Results ◽

False Negative Results

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Defining the information needs of lung cancer screening participants: a qualitative study

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2019-000448 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000448 ◽

Cited By ~ 1

Author(s):

Mamta Ruparel ◽

Samantha Quaife ◽

David Baldwin ◽

Jo Waller ◽

Samuel Janes

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Qualitative Study ◽

Focus Groups ◽

Information Needs ◽

False Negative ◽

Lung Cancer Screening ◽

Informed Decision ◽

Curative Treatment ◽

Information Materials

IntroductionLung cancer screening (LCS) by low-dose CT has been shown to improve mortality, but individuals must consider the potential benefits and harms before making an informed decision about taking part. Shared decision-making is required for LCS in USA, though screening-eligible individuals’ specific views of these harms, and their preferences for accessing this information, are not well described.MethodsIn this qualitative study, we aimed to explore knowledge and perceptions around lung cancer and LCS with a focus on harms. We carried out seven focus groups with screening-eligible individuals, which were divided into current versus former smokers and lower versus higher educational backgrounds; and 16 interviews with health professionals including general practitioners, respiratory physicians, lung cancer nurse specialists and public health consultants. Interviews and focus groups were audio-recorded and transcribed. Data were coded inductively and analysed using the framework method.ResultsFatalistic views about lung cancer as an incurable disease dominated, particularly among current smokers, and participants were often unaware of curative treatment options. Despite this, beliefs that screening is sensible and worthwhile were expressed. Generally participants felt they had the ‘right’ to an informed decision, though some cautioned against information overload. The potential harms of LCS were poorly understood, particularly overdiagnosis and radiation exposure, but participants were unlikely to be deterred by them. Strong concerns about false-negative results were expressed, while false-positive results and indeterminate nodules were also reported as concerning.ConclusionsThese findings demonstrate the need for LCS information materials to highlight information on the benefits of early detection and options for curative treatment, while accurately presenting the possible harms. Information needs are likely to vary between individuals and we recommend simple information materials to be made available to all individuals considering participating in LCS, with signposting to more detailed information for those who require it.

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