Pragmatic approach to the diagnosis of covid-19 pneumonia SARS-CoV-2 (COVID-19). from the epidemic phase to the two and three one

ABSTRACT

Pneumonia represents the main cause of hospitalization and mortality secondary to SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona-virus 2) infection. The etiological diagnosis of COVID-19 pneumonia requires confirmation of the presence of viral genetic material detected with RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction) test, usually obtained using nasopharyngeal or oropharyngeal swab;how-ever, several evidences demonstrate that a significant proportion of swabs, in particular at the first determination, results negative even in the presence of COVID-19 pneumonia. These patients may be erroneously hospitalized in a non-COVID-19 area and therefore contribute to the nosocomial transmission of the virus. For this reason the Italian Thoracic Society (ITS) promoted the production of a document that recommends a pragmatic approach to the COVID-19 pneumonia diagnosis with negative RT-PCR using a decisional clinical-radiological algorithm as a proxy to the commonly adopted gold standard, represented by RT-PCR, aimed at isolating patient and promoting investigations for a correct clinical-therapeutic classification. Difficulties in the first COVID-19 epidemic phase allowed us to know better characteristics and virus dangerousness. What we have learned has to be usefully implemented in clinical practice in order to contain the infection in the second and third phases to prevent a possible second wave of the infection during the autumnal period.