Survival in adult pneumonia inpatients fulfilling suspected COVID-19 criteria and baseline negative RT-qPCR

Abstract

\n Objective\n To evaluate the survival experience of suspicion COVID-19 hospitalized patients with pneumonia and negative baseline RT-qPCR test results.\n \n Study design\n We conducted a nationwide retrospective cohort study in Mexico.\n \n Method\n Adult pneumonia inpatients fulfilling suspected COVID-19 criteria, and hospital entry from March to August 2020, were enrolled. The Kaplan-Meier method was to use to compare survival estimates among patients with negative RT-qPCR nasopharyngeal or oropharyngeal swabs and those with a baseline positive test.\n \n Results\n Data from 64,624 individuals fulfilling suspected CoViD-19 criteria were analyzed and 1.6% of them had negative RT-qPCR tests. The overall mortality rate was higher among laboratory-positive patients (48.5% vs. 34.2%, p < 0.001) and, at any given threshold, the survival estimates were higher among RT-qPCR negative pneumonia inpatients.\n \n Conclusions\n The pathogenic mechanism of COVID-19 remains poorly understood and suspected cases with pneumonia and negative laboratory results represent a major challenge for healthcare systems. Our findings suggest that RT-qPCR negative inpatients may have an improved disease prognosis but the in-hospital mortality was still high among them. However, further research is needed to clarify the clinical and epidemiological implications of our results.\n