SSD epidemiologia e screening, CPO-AOU Città della salute e della scienza di Torino, Turin (Italy);
SSD epidemiologia e screening, CPO-AOU Città della salute e della scienza di Torino, Turin (Italy).
Epidemiol Prev. 2021;45(6):543-551. doi: 10.19191/EP21.6.124.
to investigate the combinations of clinical features and symptoms that best predict the positive outcome of the SARS-CoV-2 swab in a primary care setting.
prospective cohort study.
patients listed in the rosters of general practitioners volunteering for the study who reported flu-like symptoms and/or anosmia/ageusia between 01.03.2020 and 30.06.2020.
positive molecular swab result. The predictive value of the reported symptoms and their association with this outcome were estimated using multivariable logistic regression models, adopting an inverse probability weighting approach.
a swab was requested for 1,045 (77.2%) out of 1,354 patients included in the study: 79.6% of them were tested, with a positive result in 50.4% of cases. Patients aged 40 to 64 years (OR 1.59; 95%CI 1.09-2.33) and those older than 64 years (OR 2.64; 95%CI 1.66-4.19) showed a higher likelihood of a positive swab results, compared with younger subjects (<40 years). A positive association with a positive swab result was observed among patients reporting fever >37.5°C (OR 1.67; 95%CI: 1.18-2.36) and anosmia/ageusia (OR 1.44; 95%CI: 1.01-2.04). The predictive value of fever tended to increase with increasing age, while an opposite trend was observed for anosmia/ageusia. No difference by gender was observed.
among patients reporting flu-like symptoms in a general practice setting, fever >37.5 and anosmia/ageusia were predictive of a positive SARS-CoV-2 swab test result and this association was modified by age. Although the generalizability of these findings might be limited, this study highlights the importance of the contribution of the research conducted in primary care settings to the definition of effective and sustainable strategies to contrast the pandemic emergency.
研究在初级保健环境中，哪些临床特征和症状组合能最好地预测 SARS-CoV-2 拭子检测呈阳性。
前瞻性队列研究。
2020 年 3 月 1 日至 6 月 30 日期间，在自愿参与研究的全科医生名单中报告有流感样症状和/或嗅觉丧失/味觉丧失的患者。
分子拭子检测结果阳性。采用逆概率加权法，通过多变量逻辑回归模型，估计报告的症状及其与该结果的相关性，以评估其预测价值。
研究共纳入 1354 例患者，其中 1045 例（77.2%）患者要求进行拭子检测：79.6%的患者接受了检测，其中 50.4%的患者检测结果为阳性。与年轻患者（<40 岁）相比，40-64 岁（比值比 1.59；95%可信区间 1.09-2.33）和 64 岁以上（比值比 2.64；95%可信区间 1.66-4.19）的患者进行 SARS-CoV-2 拭子检测呈阳性的可能性更高。报告发热>37.5°C（比值比 1.67；95%可信区间：1.18-2.36）和嗅觉丧失/味觉丧失（比值比 1.44；95%可信区间：1.01-2.04）的患者与 SARS-CoV-2 拭子检测阳性结果呈正相关。发热的预测价值随着年龄的增加而增加，而嗅觉丧失/味觉丧失则呈相反趋势。未观察到性别差异。
在全科医生诊室报告有流感样症状的患者中，发热>37.5°C 和嗅觉丧失/味觉丧失是 SARS-CoV-2 拭子检测阳性结果的预测因素，这种相关性受年龄影响。尽管这些发现的普遍性可能有限，但本研究强调了初级保健环境中开展的研究对制定有效和可持续策略应对大流行紧急情况的重要性。
