INCONSISTENCIES IN DETECTING RDRP GENE BY RDRP CONFIRMATORY ASSAY LEADING TO FALSE NEGATIVE COVID-19 RESULTS: A CASE REPORT FROM A DISTRICT REFERRAL HOSPITAL

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Yong Jo Yen Mangalam Sinniah Joash Tan-Loh Nor Akmal Mokhtar Brian Cheong Mun Keong

Abstract

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.

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How to Cite
YEN, Yong Jo et al. INCONSISTENCIES IN DETECTING RDRP GENE BY RDRP CONFIRMATORY ASSAY LEADING TO FALSE NEGATIVE COVID-19 RESULTS: A CASE REPORT FROM A DISTRICT REFERRAL HOSPITAL. Journal of Health and Translational Medicine, [S.l.], p. 1 - 5, dec. 2020. ISSN 2289-392X. Available at: <https://jummec.um.edu.my/article/view/25439>. Date accessed: 01 mar. 2021.
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