Seven symptoms jointly predict COVID-19 diagnosis, study finds

Date:
September 28, 2021
Source:
PLOS
Summary:
A set of 7 symptoms, considered together, can be used to maximize
detection of COVID-19 in the community, according to researchers.



FULL STORY ==========================================================================
A set of 7 symptoms, considered together, can be used to maximize
detection of COVID-19 in the community, according to a new paper published
this week in PLOS Medicineby Marc Chadeau-Hyam and Paul Elliott of
Imperial College London, UK, and colleagues.


==========================================================================
The rapid detection of SARS-CoV-2 infection in the community is key to
ensuring efficient control of transmission. When testing capacity is
limited, it is important to use tests in the most efficient way possible, including using the most informative symptoms for test allocation. In
the new study, researchers obtained throat and nose swabs with valid
SARS-CoV-2 PCR test results from 1,147,345 volunteers in England aged 5
years and above. The data were collected over 8 testing rounds conducted between June 2020 and January 2021 as part of the REal-time Assessment
of Community Transmission-1 (REACT-1) study.

Participants were asked about symptoms they experienced in the week
prior to testing.

A model was developed based on the data obtained during rounds 2 to
7, with 7 symptoms selected as jointly positively predictive of PCR
positivity: loss or change of smell, loss or change of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The first 4
of those symptoms are currently used in the UK to determine eligibility
for community PCR testing. In round 8 of testing, the resulting model
predicted PCR positivity with an area under the curve of 0.77, and testing people in the community with at least 1 of the 7 selected positively
predictive symptoms gave sensitivity, specificity, and positive predictive values of 74%, 64%, and 9.7%, respectively. Modeling suggested that the
use of the 7 symptoms identified for PCR test allocation would result
in 30% to 40% of symptomatic individuals in England being eligible for
a test (versus 10% currently) and, if all those eligible were tested,
would result in the detection of 70% to 75% of positive cases.

"In order to improve PCR positivity detection rates and consequently
improve control of viral transmission via isolation measures, we would
propose to extend the list of symptoms used for triage to all 7 symptoms
we identified," the authors say.

"These findings suggest many people with COVID-19 won't be getting
tested - - and therefore won't be self-isolating -- because their
symptoms don't match those used in current public health guidance
to help identify infected people," Elliott adds. "We understand
that there is a need for clear testing criteria, and that including
lots of symptoms which are commonly found in other illnesses like
seasonal flu could risk people self-isolating unnecessarily. I
hope that our findings on the most informative symptoms mean
that the testing programme can take advantage of the available
evidence, helping to optimise the detection of infected people." ========================================================================== Story Source: Materials provided by PLOS. Note: Content may be edited
for style and length.


========================================================================== Journal Reference:
1. Joshua Elliott, Matthew Whitaker, Barbara Bodinier, Oliver Eales,
Steven
Riley, Helen Ward, Graham Cooke, Ara Darzi, Marc Chadeau-Hyam,
Paul Elliott. Predictive symptoms for COVID-19 in the community:
REACT-1 study of over 1 million people. PLOS Medicine, 2021; 18
(9): e1003777 DOI: 10.1371/journal.pmed.1003777 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/09/210928141836.htm

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