Abstract
ObjectiveThis cross-sectional observational study summarized the baseline characteristics of subjects who underwent COVID-19 molecular testing in a private medical centre located in the state of Selangor in Malaysia between 1 Oct 2020 and 31 Jan 2021. We compared the baseline characteristics between subjects who were tested positive and negative of SARS-CoV-2 infection, and identified risk factors which may be predictive of SARS-CoV-2 positivity.Methods and findingsA total of 36603 subjects who were tested for COVID-19 infection via molecular assays at Sunway Medical Centre between Oct 1, 2020 and Jan 31, 2021, and consented to participate in this observation study were included for analysis. Descriptive statistics was used to summarize the study cohort, whereas logistic regression analysis was used to identify risk factors associated with SARS-CoV-2 positivity. Among the reasons listed for COVID-19 screening were those who needed clearance for travelling, clearance to return to work, or clearance prior to hospital admission. They accounted for 67.7% of tested subjects, followed by the self-referred group (27.3%). Most of the confirmed cases were asymptomatic (62.6%), had no travel history (99.6%), and had neither exposure to SARS-CoV-2 confirmed cases (61.9%) nor exposure to patients under investigation (82.7%) and disease clusters (89.2%). Those who presented with loss of smell or taste (OR: 26.91; 95% CI: 14.81–48.92, p<0.001), fever (OR:3.97; 95% CI: 2.54–6.20, p<0.001), running nose (OR: 1.75; 95% CI:1.10–2.79, p = 0.019) or other symptoms (OR: 5.63; 95% CI:1.68–18.91, p = 0.005) were significantly associated with SARS-CoV-2 positivity in the multivariate logistic regression analysis.ConclusionOur study showed that majority of patients seeking COVID-19 testing in a private healthcare setting were mainly asymptomatic with low epidemiological risk. Consequently, the average positivity rate was 1.2% compared to the national cumulative positivity rate of 4.65%. Consistent with other studies, we found that loss of smell or taste, fever and running nose were associated with SARS-CoV-2 positivity. We believe that strengthening the capacity of private health institutions is important in the national battle against the COVID-19 pandemic, emphasizing the importance of public-private partnership to improve the quality of clinical care.
Highlights
As of 28 March 2021, COVID-19 had spread to 223 countries; infecting more than 126 million people and causing more than 2.7 million deaths worldwide
Our study showed that majority of patients seeking COVID-19 testing in a private healthcare setting were mainly asymptomatic with low epidemiological risk
Consistent with other studies, we found that loss of smell or taste, fever and running nose were associated with SARS-CoV-2 positivity
Summary
As of 28 March 2021, COVID-19 had spread to 223 countries; infecting more than 126 million people and causing more than 2.7 million deaths worldwide. The number of confirmed COVID-19 cases in Malaysia had risen to 341944 cases with 1255 deaths. Among the 14 states in Malaysia, Selangor was the most affected, with 122934 confirmed cases as of 23th March 2021 [1]. According to the guidelines set by the Ministry of Health Malaysia (MOH), the diagnosis of COVID-19 is made by the detection of SARS-CoV-2 via molecular-based testing. In the beginning of the COVID-19 pandemic, there were only 23 laboratories nationwide which offered up to a total of 1000 RT-PCR tests daily. Within a year’s time, Malaysia had increased the testing capacity to ~70000 tests per day, with the support of 67 laboratories nationwide. Sunway Medical Centre’s Molecular Diagnostic Laboratory is one of the pioneer private-hospital-based laboratories certified by the MOH to offer COVID-19 screening services. The digital platform served as a systematic primary source for supporting research needs, and enabled more efficient contract tracing
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