False-positive Xpert® Xpress SARS-CoV-2 assay in an emergency room and trauma center: A retrospective chart review study

Saudi Med J. 2022 Aug;43(8):965-970. doi: 10.15537/smj.2022.43.8.20220317.

Abstract

Objectives: To review reports false-positive Xpert results in an emergency room and trauma center.

Methods: Patients' data with false-positive Xpert results from November 2020 to February 2022 at Pusan National University Hospital, Busan, Republic of Korea, were extracted from the electronic medical records.

Results: The positive predictive value of Xpert was 40%. Of the 12 patients with false-positive results, 5 (41.7%) were re-positives (such as, patients recovered from coronavirus disease-19 [COVID-19]), and 4 (33.3%) had head or facial trauma. Two out of 4 head or facial trauma cases had documented sample contamination with blood.

Conclusion: We found a high incidence of false-positive Xpert results among patients who recovered from COVID-19 and those with head or facial injury. Careful history taking for COVID-19 and physical examination of the sample collection site is essential before Xpert analysis.

Keywords: COVID-19; COVID-19 nucleic acid testing; SARS-CoV-2; false positive reactions; polymerase chain reaction.

Publication types

  • Review

MeSH terms

  • COVID-19* / diagnosis
  • Emergency Service, Hospital
  • Humans
  • Retrospective Studies
  • SARS-CoV-2*
  • Trauma Centers