@article {Behrendt5112, author = {Anna Behrendt and Ladan Akbarian-Tefaghi and Lisa Amani and Thomas Burns and Sachan Maruthan and Akhilesh Mulay and Ezgi Ozcan and Rabia Warraich and Stephanie Paget and Amina Jaffer and Hannah Jarvis and Simon Brill and Dean Creer}, title = {Late Breaking Abstract - Tackling the diagnostic challenge of COVID-19 {\textendash} beyond a {\textquoteleft}false-negative{\textquoteright}?}, volume = {56}, number = {suppl 64}, elocation-id = {5112}, year = {2020}, doi = {10.1183/13993003.congress-2020.5112}, publisher = {European Respiratory Society}, abstract = {Background: The fast-evolving COVID-19 pandemic poses a significant diagnostic challenge all over the world. An understanding of the sensitivity/specificity of SARZ-CoV-2 RT-PCR helps to address the clinical challenges associated with the management of admissions with COVID-19.Aim: To determine the relative proportion of RT-PCR positive and negative adult hospital COVID-19 admissions and determine whether there are significant differences between them.Methods: In this retrospective cohort study we examined the demographics, clinical and biochemical characteristics of COVID-19 adult admissions to Barnet Hospital in the first month of the disease outbreak in the UK. SARS-CoV-2 RT-PCR-negative patients were diagnosed if alternative diagnosis was unlikely and 3 of 4 of the following were present: - classical symptoms (new persistent cough)- fever/tachypnea/hypoxia- lymphopaenia- CXR changes The primary endpoint was death at 30 days from initial presentation.Results: 572 patients were admitted with COVID-19, of whom 450 were RT-PCR positive (79\%) and 122 were RT-PCR negative (21\%). infection at Barnet Hospital in the first month.There was no significant difference in most of the studied parameters between the PCR-positive and PCR-negative COVID-19 patients. The only exception was the neutrophil count, which was found to be higher in the PCR-negative cohort (p\<0.001). View this table:Conclusion: Our study confirms that clinical criteria are effective in diagnosing COVID-19 in the presence of negative RT-PCR and has demonstrated no significant clinical differences between RT-PCR-positive and RT-PCR-negative COVID-19 admissions.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 5112.This abstract was presented at the 2020 ERS International Congress, in session {\textquotedblleft}Respiratory viruses in the "pre COVID-19" era{\textquotedblright}.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/56/suppl_64/5112}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }