Performance of COVID-19 associated symptoms and temperature checking as a screening tool for SARS-CoV-2 infection.

Autor: Nuertey BD; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Community Health Department, University of Ghana Medical School, Accra, Ghana.; Public Health Department, Tamale Teaching Hospital, Tamale, Ghana., Ekremet K; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana., Haidallah AR; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana., Mumuni K; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Department of Obstetric and Gynaecology, University of Ghana Medical School, Accra, Ghana., Addai J; Department of Medicine, Korle-Bu teaching Hospital, Accra, Ghana., Attibu RIE; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Public Health Department, Tamale Teaching Hospital, Tamale, Ghana., Damah MC; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Pharmacy Department, Tamale Teaching Hospital, Tamale, Ghana., Duorinaa E; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Department of Surgery, Tamale Teaching Hospital, Tamale, Ghana., Seidu AS; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Public Health Department, Tamale Teaching Hospital, Tamale, Ghana., Adongo VC; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Laboratory Department, Tamale Teaching Hospital, Tamale, Ghana., Adatsi RK; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Laboratory Department, Tamale Teaching Hospital, Tamale, Ghana., Suri HC; Tamale Teaching Hospital, COVID-19 Management Team, Accra, Ghana.; Intensive Care Unit, Tamale Teaching Hospital, Tamale, Ghana., Komei AA; Zonal Public Health Reference Laboratory, Tamale, Ghana., Abubakari BB; Regional Health Directorate, Northern Region, Tamale, Ghana.; School of Medical Sciences, University for development studies, Tamale, Ghana., Weyori E; Zonal Public Health Reference Laboratory, Tamale, Ghana., Allegye-Cudjoe E; Veterinary Service Laboratory, Pong-Tamale, Ghana., Sylverken A; Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Owusu M; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.; Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Phillips RO; Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Sep 17; Vol. 16 (9), pp. e0257450. Date of Electronic Publication: 2021 Sep 17 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0257450
Abstrakt: Introduction: Coronavirus disease-19 (COVID-19), which started in late December, 2019, has spread to affect 216 countries and territories around the world. Globally, the number of cases of SARS-CoV-2 infection has been growing exponentially. There is pressure on countries to flatten the curves and break transmission. Most countries are practicing partial or total lockdown, vaccination, massive education on hygiene, social distancing, isolation of cases, quarantine of exposed and various screening approaches such as temperature and symptom-based screening to break the transmission. Some studies outside Africa have found the screening for fever using non-contact thermometers to lack good sensitivity for detecting SARS-CoV-2 infection. The aim of this study was to determine the usefulness of clinical symptoms in accurately predicting a final diagnosis of COVID-19 disease in the Ghanaian setting.
Method: The study analysed screening and test data of COVID-19 suspected, probable and contacts for the months of March to August 2020. A total of 1,986 participants presenting to Tamale Teaching hospital were included in the study. Logistic regression and receiver operator characteristics (ROC) analysis were carried out.
Results: Overall SARS-CoV-2 positivity rate was 16.8%. Those with symptoms had significantly higher positivity rate (21.6%) compared with asymptomatic (17.0%) [chi-squared 15.5, p-value, <0.001]. Patients that were positive for SARS-CoV-2 were 5.9 [3.9-8.8] times more likely to have loss of sense of smell and 5.9 [3.8-9.3] times more likely to having loss of sense of taste. Using history of fever as a screening tool correctly picked up only 14.8% of all true positives of SARS-CoV-2 infection and failed to pick up 86.2% of positive cases. Using cough alone would detect 22.4% and miss 87.6%. Non-contact thermometer used alone, as a screening tool for COVID-19 at a cut-off of 37.8 would only pick 4.8% of positive SARS-CoV-2 infected patients.
Conclusion: The use of fever alone or other symptoms individually [or in combination] as a screening tool for SARS-CoV-2 infection is not worthwhile based on ROC analysis. Use of temperature check as a COVID-19 screening tool to allow people into public space irrespective of the temperature cut-off is of little benefit in diagnosing infected persons. We recommend the use of facemask, hand hygiene, social distancing as effective means of preventing infection.
Competing Interests: The authors have declared that no competing interest exist.
Databáze: MEDLINE
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