Abstract
The early identification of patients suffering from SARS-CoV-2 infection in primary care is of outmost importance in the current pandemic. The objective of this study was to describe the clinical characteristics of primary care patients who tested positive for SARS-CoV-2. We conducted a cross-sectional study between March 24 and May 7, 2020, involving consecutive patients undergoing RT-PCR testing in two community-based laboratories in Lyon (France) for a suspicion of COVID-19. We examined the association between symptoms and a positive test using univariable and multivariable logistic regression, adjusted for clustering within laboratories, and calculated the diagnostic performance of these symptoms. Of the 1561 patients tested, 1543 patients (99%) agreed to participate. Among them, 253 were positive for SARS-CoV-2 (16%). The three most frequently reported ‘ear-nose-throat’ and non-‘ear-nose-throat’ symptoms in patients who tested positive were dry throat (42%), loss of smell (36%) and loss of taste (31%), respectively fever (58%), cough (52%) and headache (45%). In multivariable analyses, loss of taste (OR 3.8 [95% CI 3.3–4.4], p-value < 0.001), loss of smell (OR 3.0 [95% CI 1.9–4.8], p < 0.001), muscle pain (OR 1.6 [95% CI 1.2–2.0], p = 0.001) and dry nose (OR 1.3 [95% CI 1.1–1.6], p = 0.01) were significantly associated with a positive result. In contrast, sore throat (OR 0.6 [95% CI 0.4–0.8], p = 0.003), stuffy nose (OR 0.6 [95% CI 0.6–0.7], p < 0.001), diarrhea (OR 0.6 [95% CI 0.5–0.6], p < 0.001) and dyspnea (OR 0.5 [95% CI 0.3–0.7], p < 0.001) were inversely associated with a positive test. The combination of loss of taste or smell had the highest diagnostic performance (OR 6.7 [95% CI 5.9–7.5], sensitivity 44.7% [95% CI 38.4–51.0], specificity 90.8% [95% CI 89.1–92.3]). No other combination of symptoms had a higher performance. Our data could contribute to the triage and early identification of new clusters of cases.
Highlights
After its emergence in China in December 2 0191,2, severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) hit Europe, which quickly became the epicenter of the epidemic in the spring of 2020
It is of utmost importance to gain a better understanding of the specific symptoms of SARS-CoV-2 infection in primary care settings in order to help general practitioners (GPs) triage patients and anticipate medical follow-up
We aimed to describe the clinical characteristics of primary care patients testing positive for SARS-CoV-2
Summary
After its emergence in China in December 2 0191,2, severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) hit Europe, which quickly became the epicenter of the epidemic in the spring of 2020. A large number of publications, some of them relatively recent, allowed us to better characterize the clinical pictures of COVID-19 patients. Most of these studies focused either on the general p opulation[7,8,9] or on inpatients[10,11,12,13] or patients presenting to the hospital or outpatient c linic[14,15,16,17]. It is of utmost importance to gain a better understanding of the specific symptoms of SARS-CoV-2 infection in primary care settings in order to help general practitioners (GPs) triage patients and anticipate medical follow-up. Equipped to receive primary care patients suspected of being infected with SARS-CoV-2, and compared symptoms of patients with positive and negative RT-PCR tests
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