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

Abstract

Clinical and laboratory findings in COVID-19 are unspecific.Chest CT has a diagnostic sensitivity comparable to nasopharyngeal swab RT-PCR assay but lacks specificity.RT-PCR assays on biological specimens, particularly nasopharyngeal swabs, are considered the diagnostic gold standard.Bronchoscopy and bronchoalveolar lavage can help confirm the diagnosis and should be performed in patients in whom diagnostic-driven treatment for COVID-19, such as tocilizumab or remdesivir, is being considered.