False-Negative Nasopharyngeal Swab RT-PCR Assays in Typical COVID-19: Role of Ultra-low-dose Chest CT and Bronchoscopy in Diagnosis

Authors

• Marco Marando General Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland
• Adriana Tamburello General Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland
• Pietro Gianella General Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland; Pneumology, Ente Ospedaliero Cantonale, Lugano, Switzerland

marco.marando@eoc.ch

Keywords

Abstract

On 11 March 2020, the WHO declared COVID-19 a pandemic and global health emergency. We describe the clinical features and role of ultra-low-dose chest computed tomography (CT) and bronchoscopy in the diagnosis of coronavirus disease (COVID-19). In our patient, who was highly suggestive clinically and radiologically for COVID-19, we had two false-negative results for nasopharyngeal and oral swab reverse-transcriptase polymerase chain reaction (RT-PCR) assays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eventually, we confirmed the diagnosis using bronchoscopy and bronchoalveolar lavage (BAL).