Abstract
Background: Symptoms associated with SARS-CoV-2 infection remain incompletely understood, especially among ambulatory, non-hospitalized individuals. Objective: Identify symptom and patient factors associated with detection of SARS-CoV-2 in outpatients. Design: Retrospective cohort analysis. Setting: An outpatient testing program in North Carolina. Patients: 20,177 individuals presenting between March 16 and September 3, 2020 for nasopharyngeal SARS-CoV-2 RNA RT-PCR testing. Measurements: Self-reported symptoms, demographic characteristics, and exposure and travel histories. Results: Among 20,177 tested individuals, the proportion positive was 9.4% (95% CI, 9.0-9.8) and was higher for men, younger individuals, and racial/ethnic minorities (all PLimitation: The study was conducted at a single large testing facility. Conclusion: In a large outpatient population in the Southeastern US, several symptoms, most notably loss of taste or smell, and greater symptom burden were associated with detection of SARS-CoV-2 RNA. Persons of color and those with who were a contact of a COVID-19 case were also more likely to test positive. These findings suggest that, given limited SARS-CoV-2 testing capacity, symptom presentation and host characteristics can be used to guide testing prioritization.Funding: Research support was provided by the National Institute of Allergy and Infectious Diseases-sponsored AIDS Clinical Trials Group (ACTG) (UM1 AI-068636), the UNC Chapel Hill AIDS Clinical Trials Unit (UM1 AI069423), the UNC Center for AIDS Research (P30 AI50410), and the NA-ACCORD COVID-19 Supplement (U01 AI069918); and the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (UL1 TR002489). This research support funded investigator effort.Declaration of Interests: There are no relevant conflicts of interest reported by the authors.Ethics Approval Statement: The study protocol was approved and granted a waiver of consent by the UNC School of Medicine Institutional Review Board.
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