{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T11:14:41Z","timestamp":1774350881251,"version":"3.50.1"},"reference-count":22,"publisher":"Walter de Gruyter GmbH","issue":"12","funder":[{"name":"Liechtenstein Government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_cclm-2020-0978_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The sensitivity of molecular and serological methods for COVID-19 testing in an epidemiological setting is not well described. The aim of the study was to determine the frequency of negative RT-PCR results at first clinical presentation as well as negative serological results after a follow-up of at least 3\u00a0weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2020-0978_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Among all patients seen for suspected COVID-19 in Liechtenstein (n=1921), we included initially RT-PCR positive index patients (n=85) as well as initially RT-PCR negative (n=66) for follow-up with SARS-CoV-2 antibody testing. Antibodies were detected with seven different commercially available immunoassays. Frequencies of negative RT-PCR and serology results in individuals with COVID-19 were determined and compared to those observed in a validation cohort of Swiss patients (n=211).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2020-0978_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among COVID-19 patients in Liechtenstein, false-negative RT-PCR at initial presentation was seen in 18% (12\/66), whereas negative serology in COVID-19 patients was 4% (3\/85). The validation cohort showed similar frequencies: 2\/66 (3%) for negative serology, and 16\/155 (10%) for false negative RT-PCR. COVID-19 patients with negative follow-up serology tended to have a longer disease duration (p=0.05) and more clinical symptoms than other patients with COVID-19 (p&lt;0.05). The antibody titer from quantitative immunoassays was positively associated with the number of disease symptoms and disease duration (p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2020-0978_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>RT-PCR at initial presentation in patients with suspected COVID-19 can miss infected patients. Antibody titers of SARS-CoV-2 assays are linked to the number of disease symptoms and the duration of disease. One in 25 patients with RT-PCR-positive COVID-19 does not develop antibodies detectable with frequently employed and commercially available immunoassays.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/cclm-2020-0978","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T13:22:27Z","timestamp":1599484947000},"page":"2131-2140","source":"Crossref","is-referenced-by-count":48,"title":["Frequency of serological non-responders and false-negative RT-PCR results in SARS-CoV-2 testing: a population-based study"],"prefix":"10.1515","volume":"58","author":[{"given":"Rita Christiane","family":"Baron","sequence":"first","affiliation":[{"name":"Psychiatrische Klinik Waldhaus , Chur , Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenz","family":"Risch","sequence":"additional","affiliation":[{"name":"Labormedizinisches zentrum Dr. Risch , Buchs , Switzerland"},{"name":"Private Universit\u00e4t im F\u00fcrstentum Liechtenstein , Triesen , Liechtenstein"},{"name":"Center of Laboratory Medicine , University Institute of Clinical Chemistry, University of Bern , Bern , Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myriam","family":"Weber","sequence":"additional","affiliation":[{"name":"Liechtensteinisches Landesspital , Heiligkreuz , Vaduz , Liechtenstein"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Thiel","sequence":"additional","affiliation":[{"name":"Liechtensteinisches Landesspital , Heiligkreuz , Vaduz , Liechtenstein"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Grossmann","sequence":"additional","affiliation":[{"name":"Private Universit\u00e4t im F\u00fcrstentum Liechtenstein , Triesen , Liechtenstein"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Wohlwend","sequence":"additional","affiliation":[{"name":"Labormedizinisches zentrum Dr. Risch , Buchs , 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Pathobiochemistry, Molecular Diagnostics , Philipps University Marburg , Marburg , Germany"},{"name":"University Hospital Giessen and Marburg , Marburg , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Flatz","sequence":"additional","affiliation":[{"name":"Institute of Immunobiology , Kantonsspital St Gallen , St Gallen , Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Kohler","sequence":"additional","affiliation":[{"name":"Cantonal Hospital St Gallen, Department of Infectious Diseases and Hospital Epidemiology , St Gallen , Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Vernazza","sequence":"additional","affiliation":[{"name":"Cantonal Hospital St Gallen, Department of Infectious Diseases and Hospital Epidemiology , St Gallen , 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