Back to Search
Start Over
COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results.
- Source :
-
PloS one [PLoS One] 2020 Jun 26; Vol. 15 (6), pp. e0235460. Date of Electronic Publication: 2020 Jun 26 (Print Publication: 2020). - Publication Year :
- 2020
-
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.<br />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 SARS-CoV-2. 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 (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.<br />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.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Adult
Ageusia virology
Asymptomatic Infections
Betacoronavirus
Body Temperature
COVID-19
COVID-19 Testing
Coronavirus Infections physiopathology
Female
Fever virology
Health Personnel
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Myalgia virology
Nasopharynx virology
Olfaction Disorders virology
Pandemics
Pharyngitis virology
Pneumonia, Viral physiopathology
Principal Component Analysis
Retrospective Studies
SARS-CoV-2
Clinical Laboratory Techniques
Coronavirus Infections diagnosis
Pneumonia, Viral diagnosis
Polymerase Chain Reaction
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 15
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 32589687
- Full Text :
- https://doi.org/10.1371/journal.pone.0235460