Please use this identifier to cite or link to this item:
https://hdl.handle.net/20.500.14279/19206
Title: | COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results |
Authors: | Lan, Fan Yun Filler, Robert Mathew, Soni Buley, Jane Iliaki, Eirini Bruno-Murtha, Lou Ann Osgood, Rebecca Osgood, Rebecca Christophi, Costas A. Fernandez-Montero, Alejandro Kales, Stefanos N. |
Major Field of Science: | Medical and Health Sciences |
Field Category: | Health Sciences |
Keywords: | Adult;Ageusia;Asymptomatic Infections;Betacoronavirus;Body Temperature;Coronavirus Infections;Female;Fever;Health Personnel;Humans;Logistic Models;Male;Middle Aged;Multivariate Analysis;Myalgia;Nasopharynx;Olfaction Disorders;Pandemics;Pharyngitis;Pneumonia, Viral;Polymerase Chain Reaction;Principal Component Analysis;Retrospective Studies |
Issue Date: | 1-Jun-2020 |
Source: | PLoS ONE, 2020, vol. 15, no. 6, article no. e0235460 |
Volume: | 15 |
Issue: | 6 |
Journal: | PLoS ONE |
Abstract: | 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 and findings 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 SARSCoV- 2. Among 592 HCWs tested, 83 (14%) had an initial positive SARS-CoV-2 assay. Fiftynine 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 (i.e. loss of smell/loss of taste) was reported less frequently (16%) than other symptoms by HCWs with positive assays, but was 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. Conclusions Symptom and temperature reports are useful screening tools for predicting SARS-CoV-2 assay results in HCWs. Anosmia/ageusia, fever, and myalgia were the strongest independent predictors of positive assays. The absence of symptoms or symptoms limited to nasal congestion/sore throat were associated with negative assays. |
URI: | https://hdl.handle.net/20.500.14279/19206 |
ISSN: | 19326203 |
DOI: | 10.1371/journal.pone.0235460 |
Rights: | © Lan et al. |
Type: | Article |
Affiliation : | National Cheng Kung University Harvard University Cyprus University of Technology University of Navarra |
Publication Type: | Peer Reviewed |
Appears in Collections: | Άρθρα/Articles |
Files in This Item:
File | Description | Size | Format | |
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COVID-19 symptoms.pdf | Open Access | 572.23 kB | Adobe PDF | View/Open |
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