AUTHOR=Gombos Katalin , Földi Mária , Kiss Szabolcs , Herczeg Róbert , Gyenesei Attila , Geiger Lili , Csabai Dávid , Futács Krisztina , Nagy Tamás , Miseta Attila , Somogyi Balázs Antal , Hegyi Péter , Szentesi Andrea 

TITLE=Analysis of COVID-19-Related RT-qPCR Test Results in Hungary: Epidemiology, Diagnostics, and Clinical Outcome

JOURNAL=Frontiers in Medicine

VOLUME=Volume 7 - 2020

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.625673

DOI=10.3389/fmed.2020.625673

ISSN=2296-858X

ABSTRACT=Background: Effective testing is an essential tool for controlling COVID-19. We aimed to analyse the data from first-wave PCR test results in Hungary’s Southern Transdanubian region to improve testing strategies.
Methods: We performed a retrospective analysis of all suspected COVID-19 cases between 17 March and 8 May 2020, collecting epidemiological, demographic, clinical and outcome data (ICU admission and mortality) with RT-qPCR test results. Descriptive and comparative statistical analyses were conducted. 
Results: Eighty-six infections were confirmed among 3,657 tested patients. There was no difference between the positive and negative cases in age and sex distribution; however, ICU admission (8.1% vs 3.1%, p=0.006) and in-hospital mortality (4.7% vs 1.6%, p=0.062) were more frequent among positive cases. Importantly, none of the initially asymptomatic patients (n=20) required ICU admission, and all survived. In almost all cases, if the first test was negative, second and third tests were performed with a 48-hour delay for careful monitoring of disease development. However, the positive hit rate decreased dramatically with the second and third tests compared to the first (0.3% vs 2.1%, OR=0.155 [0.053-0.350]). Higher E-gene copy numbers were associated with a longer period of PCR positivity.
Conclusion: In our immunologically naïve suspected COVID-19 population, coronavirus infection increased the need for intensive care and mortality by 3-4 times. In the event of the exponential phase of the pandemic involving a bottleneck in testing capacity, a second or third test should be reconsidered to diagnose more coronavirus infections.