key: cord-0699169-jjplta01
authors: Kelly, Jeannie C.; Dombrowksi, Michael; O’neil-Callahan, Micaela; Kernberg, Annessa S.; Frolova, Antonina I.; Stout, Molly J.
title: False-Negative COVID-19 Testing: Considerations in Obstetrical Care
date: 2020-04-28
journal: Am J Obstet Gynecol MFM
DOI: 10.1016/j.ajogmf.2020.100130
sha: cc74ca28b4fba19367e1dd886c7321515a808971
doc_id: 699169
cord_uid: jjplta01

nan

Introduction: Real-time reverse transcriptions-polymerase chain reaction (RT-PCR) of 4 nasopharyngeal (NP) swabs for SARS-Cov-2 are most commonly used for diagnosis of COVID- 19 5 infection, but there is limited information regarding the diagnostic test characteristics including 6 negative and positive predictive values, including in pregnancy. 7 8 Case: A primiparous woman* at 33 weeks' gestation presented to the obstetrical triage unit 9 complaining of contractions, emesis, and cough for two days. She had fever, tachycardia, 10 tachypnea, lymphopenia and mild elevation of liver enzymes. inadvertently sent out to a national reference laboratory, and thus a second test was 18 performed on day 4 of symptom in-hospital for more timely results. Both tests resulted 19 negative on that same day. Chest computed tomography revealed bilateral areas of 20 consolidation and ground-glass opacification (Figure) . All other infectious test results were 21 negative. A third NP SARS-CoV2 PCR was obtained by the ICU staff on day 4 of symptoms, in 22 case the prior two tests obtained by the obstetrical staff were limited by inadequate sampling. 23

This test also resulted as negative the next day. The patient's cardiopulmonary status further high fever requiring increasing amounts of vasopressor support, and fetal heart tracing with 26 minimal variability, the team proceeded with a primary cesarean delivery. The neonate had 27

Apgar scores of 1, 6, and 7 at 5, 10, and 15 minutes, respectively. 

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