COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results
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, sy...
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| Veröffentlicht in: | PloS one 2020-06, Vol.15 (6), p.e0235460 |
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| creator | Lan, Fan-Yun Filler, Robert Mathew, Soni Buley, Jane Iliaki, Eirini Bruno-Murtha, Lou Ann Osgood, Rebecca Christophi, Costas A Fernandez-Montero, Alejandro Kales, Stefanos N |
| description | 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.
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.
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. |
| doi_str_mv | 10.1371/journal.pone.0235460 |
| format | Article |
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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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0235460</identifier><identifier>PMID: 32589687</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Ageusia - virology ; Anosmia ; Assaying ; Asymptomatic ; Asymptomatic Infections ; Betacoronavirus ; Biology and Life Sciences ; Body Temperature ; Clinical Laboratory Techniques ; Congestion ; Coronavirus Infections - diagnosis ; Coronavirus Infections - physiopathology ; Coronaviruses ; COVID-19 ; COVID-19 Testing ; Diagnosis ; Diagnostic systems ; Diagnostic tests ; Disease prevention ; Disease transmission ; Environmental health ; Female ; Fever ; Fever - virology ; Health aspects ; Health care ; Health Personnel ; Health services ; Hospitals ; Humans ; Identification and classification ; Infections ; Infectious diseases ; Laboratories ; Logistic Models ; Male ; Medical personnel ; Medical schools ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Multivariate Analysis ; Myalgia ; Myalgia - virology ; Nasopharynx - virology ; Occupational health ; Olfaction ; Olfaction disorders ; Olfaction Disorders - virology ; Pandemics ; Pharyngitis ; Pharyngitis - virology ; Pneumonia, Viral - diagnosis ; Pneumonia, Viral - physiopathology ; Polymerase Chain Reaction ; Principal Component Analysis ; Principal components analysis ; Public health ; Research and Analysis Methods ; Retrospective Studies ; SARS-CoV-2 ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Signs and symptoms ; Smell ; Taste disorders ; Temperature ; Viral diseases ; Viruses</subject><ispartof>PloS one, 2020-06, Vol.15 (6), p.e0235460</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Lan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Lan et al 2020 Lan et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c641t-ba7787c5c80900d88aa212664550e5a8b8271fc3abae908953393a1c510475cd3</cites><orcidid>0000-0002-7712-4664 ; 0000-0001-5167-3975 ; 0000-0002-8741-7401 ; 0000-0001-8657-7422</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319316/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319316/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32589687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Adrish, Muhammad</contributor><creatorcontrib>Lan, Fan-Yun</creatorcontrib><creatorcontrib>Filler, Robert</creatorcontrib><creatorcontrib>Mathew, Soni</creatorcontrib><creatorcontrib>Buley, Jane</creatorcontrib><creatorcontrib>Iliaki, Eirini</creatorcontrib><creatorcontrib>Bruno-Murtha, Lou Ann</creatorcontrib><creatorcontrib>Osgood, Rebecca</creatorcontrib><creatorcontrib>Christophi, Costas A</creatorcontrib><creatorcontrib>Fernandez-Montero, Alejandro</creatorcontrib><creatorcontrib>Kales, Stefanos N</creatorcontrib><title>COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.</description><subject>Adult</subject><subject>Ageusia - virology</subject><subject>Anosmia</subject><subject>Assaying</subject><subject>Asymptomatic</subject><subject>Asymptomatic Infections</subject><subject>Betacoronavirus</subject><subject>Biology and Life Sciences</subject><subject>Body Temperature</subject><subject>Clinical Laboratory Techniques</subject><subject>Congestion</subject><subject>Coronavirus Infections - diagnosis</subject><subject>Coronavirus Infections - physiopathology</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 Testing</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Diagnostic tests</subject><subject>Disease prevention</subject><subject>Disease transmission</subject><subject>Environmental health</subject><subject>Female</subject><subject>Fever</subject><subject>Fever - virology</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health Personnel</subject><subject>Health services</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Identification and classification</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Laboratories</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical schools</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myalgia</subject><subject>Myalgia - virology</subject><subject>Nasopharynx - virology</subject><subject>Occupational health</subject><subject>Olfaction</subject><subject>Olfaction disorders</subject><subject>Olfaction Disorders - virology</subject><subject>Pandemics</subject><subject>Pharyngitis</subject><subject>Pharyngitis - virology</subject><subject>Pneumonia, Viral - diagnosis</subject><subject>Pneumonia, Viral - physiopathology</subject><subject>Polymerase Chain Reaction</subject><subject>Principal Component Analysis</subject><subject>Principal components analysis</subject><subject>Public health</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Signs and symptoms</subject><subject>Smell</subject><subject>Taste disorders</subject><subject>Temperature</subject><subject>Viral diseases</subject><subject>Viruses</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkluLEzEcxQdR3It-A9EBQfFhai6Ty7wIpeulslBpta8hk8m0qTOTmmRW99ub2tmlAwqSh4Tkd07-HE6SPINgAjGDb3e2d51sJnvb6QlAmOQUPEjOYYFRRhHAD0_OZ8mF9zsACOaUPk7OMCK8oJydJ59ni_X8KoNF6m_bfbCtT_dOV0YFc6NTW6dbLZuwVdLp9Kd137Xzr9PVdLnKZnadofTLbJk67fsm-CfJo1o2Xj8d9svk24f3X2efsuvFx_lsep0pmsOQlZIxzhRRHBQAVJxLiSCiNCcEaCJ5yRGDtcKylLoAvCAYF1hCRSDIGVEVvkxeHH33jfViiMELlEPGoiOjkZgficrKndg700p3K6w04s-FdRshXTCq0UIiAktGWVVindcMllzLWoKS50TjXJPo9W74rS9bXSndBSebken4pTNbsbE3guEYPzwM83IwcPZHr334x8gDtZFxKtPVNpqp1nglphQxlucFQ5Ga_IWKq9KtUbEItYn3I8GbkSAyQf8KG9l7L-ar5f-zi_WYfXXCHjvibdMHYzs_BvMjqJz13un6PjkIxKHHd2mIQ4_F0OMoe36a-r3orrj4N8dF6qY</recordid><startdate>20200626</startdate><enddate>20200626</enddate><creator>Lan, Fan-Yun</creator><creator>Filler, Robert</creator><creator>Mathew, Soni</creator><creator>Buley, Jane</creator><creator>Iliaki, Eirini</creator><creator>Bruno-Murtha, Lou Ann</creator><creator>Osgood, Rebecca</creator><creator>Christophi, Costas A</creator><creator>Fernandez-Montero, Alejandro</creator><creator>Kales, Stefanos N</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>COVID</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-7712-4664</orcidid><orcidid>https://orcid.org/0000-0001-5167-3975</orcidid><orcidid>https://orcid.org/0000-0002-8741-7401</orcidid><orcidid>https://orcid.org/0000-0001-8657-7422</orcidid></search><sort><creationdate>20200626</creationdate><title>COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results</title><author>Lan, Fan-Yun ; Filler, Robert ; Mathew, Soni ; Buley, Jane ; Iliaki, Eirini ; Bruno-Murtha, Lou Ann ; Osgood, Rebecca ; Christophi, Costas A ; Fernandez-Montero, Alejandro ; Kales, Stefanos N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c641t-ba7787c5c80900d88aa212664550e5a8b8271fc3abae908953393a1c510475cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Ageusia - virology</topic><topic>Anosmia</topic><topic>Assaying</topic><topic>Asymptomatic</topic><topic>Asymptomatic Infections</topic><topic>Betacoronavirus</topic><topic>Biology and Life Sciences</topic><topic>Body Temperature</topic><topic>Clinical Laboratory Techniques</topic><topic>Congestion</topic><topic>Coronavirus Infections - diagnosis</topic><topic>Coronavirus Infections - physiopathology</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 Testing</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Diagnostic tests</topic><topic>Disease prevention</topic><topic>Disease transmission</topic><topic>Environmental health</topic><topic>Female</topic><topic>Fever</topic><topic>Fever - virology</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Health Personnel</topic><topic>Health services</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Identification and classification</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Laboratories</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medical schools</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myalgia</topic><topic>Myalgia - virology</topic><topic>Nasopharynx - virology</topic><topic>Occupational health</topic><topic>Olfaction</topic><topic>Olfaction disorders</topic><topic>Olfaction Disorders - virology</topic><topic>Pandemics</topic><topic>Pharyngitis</topic><topic>Pharyngitis - virology</topic><topic>Pneumonia, Viral - diagnosis</topic><topic>Pneumonia, Viral - physiopathology</topic><topic>Polymerase Chain Reaction</topic><topic>Principal Component Analysis</topic><topic>Principal components analysis</topic><topic>Public health</topic><topic>Research and Analysis Methods</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Signs and symptoms</topic><topic>Smell</topic><topic>Taste disorders</topic><topic>Temperature</topic><topic>Viral diseases</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lan, Fan-Yun</creatorcontrib><creatorcontrib>Filler, Robert</creatorcontrib><creatorcontrib>Mathew, Soni</creatorcontrib><creatorcontrib>Buley, Jane</creatorcontrib><creatorcontrib>Iliaki, Eirini</creatorcontrib><creatorcontrib>Bruno-Murtha, Lou Ann</creatorcontrib><creatorcontrib>Osgood, Rebecca</creatorcontrib><creatorcontrib>Christophi, Costas A</creatorcontrib><creatorcontrib>Fernandez-Montero, Alejandro</creatorcontrib><creatorcontrib>Kales, Stefanos N</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lan, Fan-Yun</au><au>Filler, Robert</au><au>Mathew, Soni</au><au>Buley, Jane</au><au>Iliaki, Eirini</au><au>Bruno-Murtha, Lou Ann</au><au>Osgood, Rebecca</au><au>Christophi, Costas A</au><au>Fernandez-Montero, Alejandro</au><au>Kales, Stefanos N</au><au>Adrish, Muhammad</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-06-26</date><risdate>2020</risdate><volume>15</volume><issue>6</issue><spage>e0235460</spage><pages>e0235460-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32589687</pmid><doi>10.1371/journal.pone.0235460</doi><tpages>e0235460</tpages><orcidid>https://orcid.org/0000-0002-7712-4664</orcidid><orcidid>https://orcid.org/0000-0001-5167-3975</orcidid><orcidid>https://orcid.org/0000-0002-8741-7401</orcidid><orcidid>https://orcid.org/0000-0001-8657-7422</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-06, Vol.15 (6), p.e0235460 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2417790076 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Ageusia - virology Anosmia Assaying Asymptomatic Asymptomatic Infections Betacoronavirus Biology and Life Sciences Body Temperature Clinical Laboratory Techniques Congestion Coronavirus Infections - diagnosis Coronavirus Infections - physiopathology Coronaviruses COVID-19 COVID-19 Testing Diagnosis Diagnostic systems Diagnostic tests Disease prevention Disease transmission Environmental health Female Fever Fever - virology Health aspects Health care Health Personnel Health services Hospitals Humans Identification and classification Infections Infectious diseases Laboratories Logistic Models Male Medical personnel Medical schools Medicine Medicine and Health Sciences Middle Aged Multivariate Analysis Myalgia Myalgia - virology Nasopharynx - virology Occupational health Olfaction Olfaction disorders Olfaction Disorders - virology Pandemics Pharyngitis Pharyngitis - virology Pneumonia, Viral - diagnosis Pneumonia, Viral - physiopathology Polymerase Chain Reaction Principal Component Analysis Principal components analysis Public health Research and Analysis Methods Retrospective Studies SARS-CoV-2 Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Signs and symptoms Smell Taste disorders Temperature Viral diseases Viruses |
| title | COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results |
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