How to Prevent Rehospitalization in Patients with COVID-19

Abstract

Aim: False-negativity of reverse-transcriptase–polymerase-chain-reaction (RT-PCR) for patients with 2019 Novel Coronavirus (COVID-19) via throat swab was discussed. Method: A total of 260 patients were diagnosed with COVID-19 RT-PCR for samples obtained via throat swab. Result: Positive rates of chest Computed tomography (CT) imaging were 96.99% (252/260). Positive rates of RT-PCR were 87.70% for the first time, 92.30% for two times, and 100% for three times. Multiple RT-PCR assay tests resulted in a high positive rate of RTPCR. Combined chest CT scans and RT-PCR lead to a positive rate of 100% even for the first testing, which is conducive to COVID-19 diagnosis. Two patients with COVID-19 were discharged from hospital with false-negative results of RT-PCR using the oropharyngeal swab. There was a significant progression on CT images and an increase in infective markers during their second admission to hospital, which indicated the progressing inflammation. Patients with complete recovery were selected. Symptoms were relieved; dissipation almost completely disappeared on CT image; and infective markers significantly decreased to normal levels, which indicated that the inflammation was not progressing. percent of lymphocyte percent (LYM) increased to normal level. Conclusion: Serial follow-up chest CT scans are quite important for confirming the patients with COVID-19 who resulted negative for RT-PCR of 2019-nCoV nucleic acid. A combination of the RT-PCR test for 2019-nCoV nucleic acid and other detective methods, such as CT imaging are conducive to diagnosis. The roadmap of how to avoid being rehospitalized for patients with COVID-19 was provided. Patients were not allowed to be discharged from hospital even with negative result of RT-PCR of 2019-nCoV nucleic acid.