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10.1371/journal.pone.0235460

http://scihub22266oqcxt.onion/10.1371/journal.pone.0235460
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32589687!7319316!32589687
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suck abstract from ncbi


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pmid32589687      PLoS+One 2020 ; 15 (6): e0235460
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  • COVID-19 symptoms predictive of healthcare workers SARS-CoV-2 PCR results #MMPMID32589687
  • Lan FY; Filler R; Mathew S; Buley J; Iliaki E; Bruno-Murtha LA; Osgood R; Christophi CA; Fernandez-Montero A; Kales SN
  • PLoS One 2020[]; 15 (6): e0235460 PMID32589687show ga
  • 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 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 degrees 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.
  • |*Clinical Laboratory Techniques[MESH]
  • |*Polymerase Chain Reaction[MESH]
  • |Adult[MESH]
  • |Ageusia/virology[MESH]
  • |Asymptomatic Infections[MESH]
  • |Betacoronavirus[MESH]
  • |Body Temperature[MESH]
  • |COVID-19[MESH]
  • |COVID-19 Testing[MESH]
  • |Coronavirus Infections/*diagnosis/physiopathology[MESH]
  • |Female[MESH]
  • |Fever/virology[MESH]
  • |Health Personnel[MESH]
  • |Humans[MESH]
  • |Logistic Models[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Multivariate Analysis[MESH]
  • |Myalgia/virology[MESH]
  • |Nasopharynx/virology[MESH]
  • |Olfaction Disorders/virology[MESH]
  • |Pandemics[MESH]
  • |Pharyngitis/virology[MESH]
  • |Pneumonia, Viral/*diagnosis/physiopathology[MESH]
  • |Principal Component Analysis[MESH]
  • |Retrospective Studies[MESH]


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