COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results
| Autor: | Rebecca Osgood, Alejandro Fernández-Montero, Soni Mathew, Costas A. Christophi, Jane Buley, Stefanos N. Kales, Robert M. Filler, Eirini Iliaki, Lou Ann Bruno-Murtha, Fan Yun Lan |
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| Rok vydání: | 2020 |
| Předmět: |
myalgia
Male Critical Care and Emergency Medicine Pulmonology Physiology viruses Fevers Artificial Gene Amplification and Extension Disease medicine.disease_cause Pathology and Laboratory Medicine Medical and Health Sciences Polymerase Chain Reaction Body Temperature Olfaction Disorders 0302 clinical medicine COVID-19 Testing Nasopharynx Pandemic Sore throat Medicine and Health Sciences Coughing 030212 general & internal medicine skin and connective tissue diseases Asymptomatic Infections Coronavirus Principal Component Analysis Multidisciplinary biology virus diseases Pharyngitis Middle Aged Institutional review board Physiological Parameters Medicine Female medicine.symptom Anatomy Coronavirus Infections Research Article Adult medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Fever Science Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Health Personnel education Pneumonia Viral Anosmia Pain Nasal congestion Research and Analysis Methods Asymptomatic Virus Throat 03 medical and health sciences Betacoronavirus Signs and Symptoms Diagnostic Medicine Internal medicine Health Sciences medicine Humans Molecular Biology Techniques Pandemics Molecular Biology Retrospective Studies business.industry Clinical Laboratory Techniques SARS-CoV-2 fungi COVID-19 Biology and Life Sciences Retrospective cohort study Myalgia Reverse Transcriptase-Polymerase Chain Reaction biology.organism_classification medicine.disease Virology body regions Pneumonia Logistic Models Dyspnea Multivariate Analysis Triage business Ageusia Physiological Processes 030217 neurology & neurosurgery Neck Revers transcriptase-polymerase chain reaction Body temperature |
| Zdroj: | PLoS ONE PLOS ONE, 15(6):e0235460 PLoS ONE, Vol 15, Iss 6, p e0235460 (2020) |
| ISSN: | 1932-6203 |
| Popis: | Background: Coronavirus 2019 disease (COVID-19) is caused by the virus SARS-CoV-2, transmissible both person-to-person and from contaminated surfaces. Early COVID-19 detection among healthcare workers (HCWs) is crucial for protecting patients and the healthcare workforce. Because of limited testing capacity, symptom-based screening may prioritize testing and increase diagnostic accuracy. Methods: We performed a retrospective study of HCWs undergoing both COVID-19 telephonic symptom screening and nasopharyngeal SARS-CoV-2 assays during the period, March 9 – April 15, 2020. HCWs with negative assays but progressive symptoms were re-tested for SARS-CoV-2. Findings: Among 592 HCWs tested, 83 (14%) had an initial positive SARS-CoV-2 assay. Fifty-nine of 61 HCWs (97%) who were asymptomatic or reported only sore throat/nasal congestion had negative SARS-CoV-2 assays (P=0·006). HCWs reporting three or more symptoms had an increased multivariate-adjusted odds of having positive assays, 1·95 (95% CI: 1·10–3·64), which increased to 2·61 (95% CI: 1·50–4·45) for six or more symptoms. The multivariate-adjusted odds of a positive assay were also increased for HCWs reporting fever and a measured temperature ≥ 37·5°C (3·49 (95% CI: 1·95–6·21)), and those with myalgias (1·83 (95% CI: 1·04–3·23)). Anosmia/ageusia was reported less frequently (16%) than other symptoms by HCWs with positive assays, but associated with more than a seven-fold multivariate-adjusted odds of a positive test: OR=7·21 (95% CI: 2·95–17·67). Of 509 HCWs with initial negative SARS-CoV-2 assays, nine had symptom progression and positive re-tests, yielding an estimated negative predictive value of 98·2% (95% CI: 96·8–99·0%) for the exclusion of clinically relevant COVID-19. Interpretation: Symptom and temperature reports are useful screening tools for predicting SARS-CoV-2 assay results in HCWs. Anosmia/ageusia and fever were the two strongest independent predictors of positive assays. The absence of symptoms or symptoms limited to nasal congestion/sore throat were associated with negative assays. Funding Statement: None. Declaration of Interests: None Ethics Approval Statement: The Institutional Review Board of the healthcare system reviewed the study protocol, determined it to be exempt and waived informed consent based on the use of existing, HIPAA-deidentified data. |
| Databáze: | OpenAIRE |
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