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ForwardWMJ Vol 119: Utilization and Results of Repeat SARS-CoV-2 RT-PCR Testing in a Presumptive Low Prevalence Population
ABSTRACT
Introduction: Early reports have raised concerns regarding the clinical sensitivity of nasopharyngeal SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) testing for patients with COVID-19 symptoms, which has led to requests for repeat testing at our institution. However, to our knowledge, there are no reports to date of the utilization or results of repeat testing to help guide this practice.
Methods: The authors searched the institutional laboratory information system for consecutive patients who were tested for SARS-CoV-2 by RT-PCR of a nasopharyngeal specimen over a 1-month period. Characteristics and results of patients who received a single or multiple tests were documented and analyzed.
Results: Six thousand three (6003) tests were performed on 5757 patients; 272 (4.7%) patients were positive based on their initial test results. Two hundred thirty-six (4%) patients were tested more than once, with 226 (96%) tested twice. The largest proportion of these patients (n=160, 71%) were those who had an initial negative test followed by a repeat test for persistent symptoms. This group included all 7 patients who had discordant positive results on their second test; the result concordance rate within this group was 96%.
Conclusion: In a population of patients with a low positive rate for SARS-CoV-2 by nasopharyngeal RT-PCR testing, repeat nasopharyngeal testing of negative patients who have persistent symptoms still yields a negative result in 96% of the cases.
Intended Audience
The target audience for this journal-based activity is healthcare providers caring for the people and communities of Wisconsin and beyond.
Learning Objectives
As a result of this journal-based activity, learners will be able to:
- Identify current testing methods for SARS-CoV-2 infection at UW Health Clinical Laboratories.
- Outline the utilization and interpretation of results of single versus repeat testing in a low disease prevalence population with persistent symptoms.
- Develop a judicious clinical approach based on data presented when repeat SARS-CoV-2-RT-PCR testing is considered in patients with persistent symptoms who previously tested negative.
FACULTY DISCLOSURE
It is the policy of the University of Wisconsin–Madison ICEP that the faculty, authors, planners, and other persons who may influence content of this CE activity disclose all relevant financial relationships with commercial interests* in order to allow CE staff to identify and resolve any potential conflicts of interest. Faculty must also disclose any planned discussions of unlabeled/unapproved uses of drugs or devices during the educational activity.
For this educational activity all conflicts of interests have been resolved and detailed disclosures are listed below:
| Name of Individual | Individual's Role in Activity | Name of Commercial Interest & | Discussion of |
| Kartikey Acharya, MD, MPH | Reviewer | No Relevant Financial Relationships to Disclose | No |
| Terese Bailey, BS | Accreditation Specialist | No Relevant Financial Relationships to Disclose | No |
| Derrick J. Chen, MD | Author | No Relevant Financial Relationships to Disclose | No |
| David Dwyer, PhD, RN, NE-BC | Reviewer | University of Wisconsin-Madison (Employment); Eskenazi Health (Spouse/Partner: Employment); Mayo Clinic (Spouse/Partner: Employment); Indiana University (Spouse/Partner: Grant) | No |
| S. Krisztian Kovacs, MD | Author | No Relevant Financial Relationships to Disclose | No |
| Michael McCormick, MD | Reviewer | No Relevant Financial Relationships to Disclose | No |
| Jill Palmer, MT | Author | No Relevant Financial Relationships to Disclose | No |
| Roberta Pawlak, PhD, RN, NEA-BC | Reviewer | No Relevant Financial Relationships to Disclose | No |
| William Rehrauer, PhD | Author | No Relevant Financial Relationships to Disclose | No |
| Sarina Schrager, MD | Editor | No Relevant Financial Relationships to Disclose | No |
| David T. Yang, MD | Author | No Relevant Financial Relationships to Disclose | No |
* The ACCME defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests.
Accreditation
Accreditation Statement
 | In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. |
Credit Designation Statements
American Medical Association (AMA)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
American Nurses Credentialing Center (ANCC)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.
Iowa Board of Nursing accepts ANCC contact hours for nursing continuing education requirements.
Continuing Education Units
The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC Contact Hours
- 1.00 University of Wisconsin–Madison Continuing Education Hours
- 1.00 Approved for AMA PRA Category 1 Credit™