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美国成年人在居家令高峰期间的 COVID-19 患病率及其预测因素。

COVID-19 prevalence and predictors in United States adults during peak stay-at-home orders.

机构信息

YourCareChoice, Ann Arbor, Michigan, United States of America.

Acumen Health Research Institute, Ann Arbor, Michigan, United States of America.

出版信息

PLoS One. 2021 Jan 22;16(1):e0245586. doi: 10.1371/journal.pone.0245586. eCollection 2021.

Abstract

BACKGROUND

Early recognition of COVID-19 cases is essential for effective public health measures aimed at isolation of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). The objective of this study was to describe characteristics, self-reported symptoms, and predictors of testing positive for SARS-CoV-2 infection in a community-based sample.

METHODS AND FINDINGS

This was a cross-sectional nationwide survey of adults in the US conducted between April 24 through May 13, 2020. The survey targeted a representative sample of approximately 5,000 respondents. The rate of COVID-19 cases and testing, most frequently reported symptoms, symptom severity, treatment received, impact of COVID-19 on mental and physical health, and factors predictive of testing positive were assessed. Most of the 5,203 participants (85.6%) reported no COVID-19-like symptoms. Of the 747 (14.5%) participants reporting COVID-19-like symptoms, 367 (49.1%) obtained a diagnostic test. Eighty-nine participants (24.3%) reported a positive COVID-19 test result, representing 1.7% of the total sample. For those testing positive, the most common symptoms were dry cough, fever, and shortness of breath/difficulty breathing. Those who tested positive were more likely to report greater symptom severity versus those who tested negative. Severe dry cough, new loss of taste or smell, trouble waking up, living with someone experiencing symptoms, recent international travel, respiratory issues, and reporting ethnicity of Black or African American were predictive of testing positive.

CONCLUSIONS

This study assessed the impact of COVID-19 using community-level self-reported data across the US during the peak of most stay at home' orders. Self-reported symptoms and risk factors identified in this study are consistent with the clinical profile emerging for COVID-19. In the absence of widespread testing, this study demonstrates the utility of a representative US community-based sample to provide direct-reported symptoms and outcomes to quickly identify high-risk individuals who are likely to test positive and should consider taking greater precautions.

摘要

背景

及早识别 COVID-19 病例对于采取旨在隔离严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染者的有效公共卫生措施至关重要。本研究的目的是描述基于社区的样本中 SARS-CoV-2 感染检测呈阳性者的特征、自我报告症状和预测因素。

方法和发现

这是一项在美国进行的全国性横断面研究,于 2020 年 4 月 24 日至 5 月 13 日进行。该调查针对的是大约 5000 名受访者的代表性样本。评估了 COVID-19 病例和检测率、最常报告的症状、症状严重程度、接受的治疗、COVID-19 对心理健康和身体健康的影响以及预测检测呈阳性的因素。大多数 5203 名参与者(85.6%)报告没有 COVID-19 样症状。在 747 名(14.5%)报告 COVID-19 样症状的参与者中,有 367 名(49.1%)进行了诊断性检测。有 89 名参与者(24.3%)报告 COVID-19 检测呈阳性,占总样本的 1.7%。对于检测呈阳性者,最常见的症状是干咳、发热和呼吸急促/呼吸困难。与检测呈阴性者相比,检测呈阳性者更有可能报告症状更严重。严重干咳、新丧失味觉或嗅觉、难以醒来、与出现症状者同住、近期国际旅行、呼吸道问题以及报告族裔为黑人或非裔美国人,是检测呈阳性的预测因素。

结论

本研究使用美国各地社区层面的自我报告数据评估了 COVID-19 在大多数“居家”令期间的影响。本研究中确定的自我报告症状和危险因素与 COVID-19 的临床特征一致。在未广泛进行检测的情况下,本研究表明,具有代表性的美国社区样本可用于提供直接报告的症状和结果,以便快速识别可能检测呈阳性且应考虑采取更多预防措施的高风险个体。

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