Diagnosing COVID-19 infection: the danger of over-reliance on positive test results

Unlike previous epidemics, in addressing COVID-19 nearly all international health organizations and national health ministries have treated a single positive result from a PCR-based test as confirmation of infection, even in asymptomatic persons without any history of exposure. This is based on a widespread belief that positive results in these tests are highly reliable. However, data on PCR-based tests for similar viruses show that PCR-based testing produces enough false positive results to make positive results highly unreliable over a broad range of real-world scenarios. This has clinical and case management implications, and affects an array of epidemiological statistics, including the asymptomatic ratio, prevalence, and hospitalization and death rates. Steps should be taken to raise awareness of false positives, reduce their frequency, and mitigate their effects. In the interim, positive results in asymptomatic individuals that haven't been confirmed by a second test should be considered suspect. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted August 18, 2020. ; https://doi.org/10.1101/2020.04.26.20080911 doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.