Epidemiology and Infectious DiseasesEpidemiology and Infectious Diseases1560-95292411-3026Eco-Vector10477010.17816/EID104770Research ArticleDifficulties in diagnosing the severe coronavirus disease COVID-19 with a negative PCR test resultKharisovaSaida R.<p>MD</p>saida.musaeva.r@gmail.comhttps://orcid.org/0000-0001-5668-2408MukhametshinaEmma I.<p>MD</p>emmaim@mail.ruhttps://orcid.org/0000-0002-9778-8302AbdulkhakovSayar R.<p>MD, Cand. Sci. (Med.), Associate Professor</p>sayarabdul@yandex.ruhttps://orcid.org/0000-0001-9542-3580GaifullinaRaushaniia F.<p>MD, Cand. Sci. (Med.), Associate Professor</p>RFGajfullina@kpfu.ruhttps://orcid.org/0000-0002-0922-5850Kazan (Volga region) Federal UniversityUniversity Clinic of Kazan (Volga region) Federal University150520212631271341203202219042022Copyright © 2021, Eco-vector2021<p>The clinical case in this article describes the topic of current interest concerning the diagnostic methods for coronavirus disease (COVID-19). The diagnostic process was hindered by nonspecific initial symptoms and twice negative results of the PCR test. For the next several days, the worsening in dynamics was observed in terms of symptoms and laboratory test results, specific to acute kidney injury, hypercoagulability syndrome and multiple organ failure. Ongoing monitoring of lungs via computed tomography revealed the typical for COVID-19 image of lungs (including ground-glass opacity and pulmonary consolidation). With suspected coronavirus disease the patients sample was transferred to the University research laboratory for a serologic test to detect IgG antibodies. The positive result of the test confirmed that the patient had COVID-19. The prescribed anticoagulants and glucocorticosteroids improved the condition. The described clinical case acknowledges the complexity of the PCR test, therefore full investigation and other tests are recommended in the case of suspected coronavirus disease.</p>general practiceinfectious disease medicinecoronaviruspolymerase chain reactiondisseminated intravascular coagulationenzyme-linked immunosorbent assayклинический случайкоронавирусная инфекцияCOVID-19полимеразная цепная реакциягиперкоагуляционный синдроммикротромбозыиммуноферментный анализ[Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA. 2020;323(18):1843–1844. doi: 10.1001/jama.2020.3786][Long QX, Liu BZ, Deng HJ, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. 2020;26(6):845–848. doi: 10.1038/s41591-020-0897-1][Ye Q, Wang B, Mao J. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. J Infect. 2020;80(6):607–613. doi: 10.1016/j.jinf.2020.03.037][Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–847. doi: 10.1111/jth.14768][Povalyaev D. The efficacy of adjuvant use low molecular weight heparins in patients with community-acquired pneumonia. Eur Respir J. 2014;44(Suppl. 58):2503.][Tang N, Bai H, Chen X, et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094–1099. doi: 10.1111/jth.14817]