Document Type : Original Article


1 Department of Pharmacology, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India

2 Department of Pharmacology, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, India

3 Department of Public Health, Institute of Public Health, Hyderabad, Telangana, India


BACKGROUND: Diagnostic dilemma arises when patients with clinical suspicion of COVID‑19
disease having moderate‑to‑severe respiratory symptoms yield negative result for COVID‑19 in
reverse transcription polymerase chain reaction (RT‑PCR). This study evaluated the clinical, laboratory
and HRCT thorax findings among RT‑PCR‑negative COVID‑19 suspects with moderate‑to‑severe
MATERIALS AND METHODS: A hospital‑based retrospective observational study was conducted
between July 2021 to December 2021, among 60 moderate and severe symptomatic COVID‑19
suspects admitted in the severe acute respiratory illness (SARI) ward and intensive care unit (ICU),
who were negative for COVID‑19 in RT‑PCR. Data were abstracted from the medical records section
of the hospital using a predesigned data abstraction form and presented by descriptive statistics.
RESULTS: Mean age of study participants was 55.5 years (SD 14.1 years), and majority were
males (n = 43, 71.7%). Common presenting symptoms were fever (n = 60, 100%), dyspnea
(n = 57, 95%), and cough (n = 54, 90%). The common laboratory findings were rise of C‑reactive
protein (n = 60, 100%), NLR (n = 49, 81.7%), d‑dimer (n = 47, 78.3%), ferritin (n = 46, 76.7%), and
LDH (n = 40, 66.7%). HRCT scan of thorax revealed ground glass opacities with or without consolidations
located bilaterally with diffuse or peripheral distribution, interlobar septal thickening (n = 43, 74.1%),
vascular thickening (n = 35, ≥58.3%), and sub‑pleural lines (n = 32, 53.3%). Median CT‑SS value
was 15 (IQR 11–19), and majority (n = 56, 93.3%) belonged to CO‑RADS ≥4.
CONCLUSION: Diagnosis of COVID‑19 can be presumed in RT‑PCR‑negative suspected
COVID‑19 patients with moderate‑to‑severe disease, with marked rise of inflammatory markers and
HRCT revealing typical findings of COVID‑19 pneumonia.


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