COVID-19测试阳性：在加利福尼亚州基于社区的大型测试计划中，各种症状的预测价值,medRxiv - Public and Global Health

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COVID-19测试阳性：在加利福尼亚州基于社区的大型测试计划中，各种症状的预测价值
medRxiv - Public and Global Health Pub Date : 2021-03-05 , DOI: 10.1101/2021.03.03.21252014
Dave P. Miller , Scott Morrow , Robert M. Califf , Cameron Kaiser , Ritu Kapur , Casimir Starsiak , Jessica Mega , William J. Marks

背景：在医院环境中捕获了许多有关COVID-19症状的早期数据。在社区中，最能预测SARS-CoV-2阳性的症状可能有所不同。这里提供了来自COVID-19社区测试计划的加利福尼亚站点的数据。方法：在接受测试之前，Baseline COVID-19测试计划的参与者完成了一个在线筛查，他们在其中自我报告了基本的人口统计学信息以及是否存在10种症状。阳性和阴性COVID-19 RT-PCR测试都链接回筛选数据。使用广义估计方程拟合阳性的多变量模型，将测试月份作为固定影响进行调整，并考虑每个测试站点内的数据聚类。结果：在2020年加利福尼亚州的547,018项首次测试中，筛查时无症状，无症状或有2种或更多症状的受试者的阳性率分别为3.4％，9.9％和19.8％。调整其他症状时，所有十个症状分别与较高的阳性率相关，但十个症状中只有六个与较高的阳性率相关。具有最高预测价值的主要症状是近期味觉或嗅觉丧失，发烧和咳嗽-OR分别为3.27、1.97和1.95。呼吸急促，呕吐或腹泻与调整其他症状的阳性率呈负相关，并且在没有其他症状的情况下，具有这些症状的参与者的阳性率没有无症状参与者高。结论：

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COVID-19 test positivity: predictive value of various symptoms in a large community-based testing program in California

Background: Much of the early data on COVID-19 symptomatology was captured in the hospital setting. In a community setting the symptoms most predictive of SARS-CoV-2 positivity may be different. Data from the California sites of a COVID-19 community testing program are presented here. Methods: Prior to being tested, participants in the Baseline COVID-19 Testing Program completed an online screener, in which they self-reported basic demographics and the presence or absence of 10 symptoms. Both positive and negative COVID-19 RT-PCR tests were linked back to the screener data. A multivariable model of positivity was fit using generalized estimating equations, adjusting for month of testing as a fixed effect and accounting for clustering of data within each test site. Results: Among 547,018 first-time tests in California in 2020, positivity rates were 3.4%, 9.9%, and 19.8% for participants with no symptoms, 1 symptom, or 2 or more symptoms at the time of screening, respectively. All ten symptoms were individually associated with higher positivity rates, but only six of ten symptoms were associated with higher positivity when adjusting for other symptoms. Major symptoms with highest predictive value were recent loss of taste or smell, fever, and coughing--with ORs of 3.27, 1.97, and 1.95, respectively. Shortness of breath and vomiting or diarrhea were negatively associated with positivity adjusting for other symptoms and, absent other symptoms, participants with these symptoms did not have significantly higher positivity rates than asymptomatic participants. Conclusions: Recent loss of taste and smell should be elevated to a major symptom along with fever and coughing in public health messaging and in our community approach to testing and surveillance, while mild to moderate shortness of breath should be de-emphasized as a sensitive early predictor of COVID-19 positivity.

更新日期：2021-03-05

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