Why people with Covid-19 symptoms are still tested negative?

These days, many people with COVID-19 symptoms have been tested negative. Doctors suspecting many reasons for such negative results such as poor quality of sampling and testing, mutations of the virus escaping detection, the efficacy of COVID testing kits, and so on. 

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As India is struggling to cope with the growing demand for RT-PCR testing kits, reports suggests that more than 20% of patients with Covid-19 symptoms are testing negative. This false result is creating great problems as serious patients may deny hospital admission because of the negative result while letting the virus spread all over the body. This trend has prompted the medical experts. The AIIMS Director, Dr Randeep Guleria has recommended Covid-19 treatment for everyone having classic symptoms irrespective of negative results. As per the reports, doctors consider RT-PCR test as gold standard in the diagnosis of Covid-19 are not meant to be the perfect. The minimum sensitivity required by Indian Council of Medical Research (ICMR) for Covid-19 test is 95% which means 5% negative results can be expected. 

Based on theoretical research, there are mainly four board factors that determine the accuracy of RT-PCR test such as, the level of viral infection in the body of the person, the quality of sample collection and testing, the efficiency or the efficacy of the testing kit and the benchmark for interpretation of test. 

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A number of patients who have been tested Covid negative in RT-PCR assessment have subsequently been confirmed Covid-19 positive in Bronchoalveolar Lavage or BAL test which collects samples from the lower respiratory tract through bronchoscope. This led to the conclusion that there are certain mutants which bypass the upper respiratory tract and affect the lung but this may bypass an RT-PCR test based on the sample collected from throat and nasal cavity.

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