{"doi":"10.1111/joim.13213","title":"Patterns of repeated diagnostic testing for COVID‐19 in relation to patient characteristics and outcomes","abstract":"BACKGROUND: Whilst the COVID-19 diagnostic test has a high false-negative rate, not everyone initially negative is re-tested. Michigan Medicine, a primary regional centre, provided an ideal setting for studying testing patterns during the first wave of the pandemic. OBJECTIVES: To identify the characteristics of patients who underwent repeated testing for COVID-19 and determine if repeated testing was associated with downstream outcomes amongst positive cases. METHODS: Characteristics, test results, and health outcomes for patients presenting for a COVID-19 diagnostic test were collected. We examined whether patient characteristics differed with repeated testing and estimated a false-negative rate for the test. We then studied repeated testing patterns in patients with severe COVID-19-related outcomes. RESULTS: Patient age, sex, body mass index, neighbourhood poverty levels, pre-existing type 2 diabetes, circulatory, kidney, and liver diseases, and cough, fever/chills, and pain symptoms 14 days prior to a first test were associated with repeated testing. Amongst patients with a positive result, age (OR: 1.17; 95% CI: (1.05, 1.34)) and pre-existing kidney diseases (OR: 2.26; 95% CI: (1.41, 3.68)) remained significant. Hospitalization (OR: 7.88; 95% CI: (5.15, 12.26)) and ICU-level care (OR: 6.93; 95% CI: (4.44, 10.92)) were associated with repeated testing. The estimated false-negative rate was 23.8% (95% CI: (19.5%, 28.5%)). CONCLUSIONS: Whilst most patients were tested once and received a negative result, a meaningful subset underwent multiple rounds of testing. These results shed light on testing patterns and have important implications for understanding the variation of repeated testing results within and between patients.","journal":"Journal of Internal Medicine","year":2020,"id":77649,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":19,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9536,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":404471,"name":"Zhangchen Zhao","orcid":"0000-0002-7990-2589","position":1,"is_corresponding":false},{"id":243516,"name":"Swaraaj Prabhu Sankar","orcid":null,"position":2,"is_corresponding":false},{"id":240110,"name":"Maxwell Salvatore","orcid":"0000-0002-3659-1514","position":3,"is_corresponding":false},{"id":240108,"name":"Tian Gu","orcid":"0000-0002-0856-8843","position":4,"is_corresponding":false},{"id":14655,"name":"Lars G. Fritsche","orcid":"0000-0002-2110-1690","position":5,"is_corresponding":false},{"id":404472,"name":"Sang Hyun Lee","orcid":"0000-0002-2246-7440","position":6,"is_corresponding":false},{"id":74974,"name":"Lynda D. Lisabeth","orcid":"0000-0001-5539-5933","position":7,"is_corresponding":false},{"id":240111,"name":"Thomas S. Valley","orcid":"0000-0002-5766-4970","position":8,"is_corresponding":false},{"id":240115,"name":"Bhramar Mukherjee","orcid":"0000-0003-0118-4561","position":9,"is_corresponding":false},{"id":404470,"name":"Stephen Salerno","orcid":"0000-0003-2763-0494","position":0,"is_corresponding":true}],"reference_count":14,"raw_metadata":null,"created_at":"2026-07-18T21:49:16.197289Z","pmid":"33253457","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}