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

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

doi:10.3389/fmed.2020.625673

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

Front Med (Lausanne). 2021 Jan 26:7:625673. doi: 10.3389/fmed.2020.625673. eCollection 2020.

Authors

Katalin Gombos¹, Mária Földi^{2

3

4}, Szabolcs Kiss^{2

3

4}, Róbert Herczeg⁵, Attila Gyenesei^{5

6}, Lili Geiger^{1

7}, Dávid Csabai^{1

7}, Krisztina Futács¹, Tamás Nagy¹, Attila Miseta¹, Balázs Antal Somogyi⁸, Péter Hegyi^{2

3

4}, Andrea Szentesi^{2

3

4}

Affiliations

¹ Department of Laboratory Medicine, Clinical Center, Medical School, University of Pécs, Pécs, Hungary.
² Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
³ Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
⁴ Centre for Translational Medicine, Department of Medicine, University of Szeged, Szeged, Hungary.
⁵ Bioinformatics Research Group, Genomics and Bioinformatics Core Facility, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
⁶ Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland.
⁷ Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
⁸ National Virology Laboratory, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.

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-h 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.

Keywords: COVID-19; PCR diagnostics; SARS-CoV-2; epidemiology; surveillance; testing.