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卡塔尔基层医疗环境中 COVID-19 诊断因素的预测能力

Predictive Ability of Factors in diagnosing COVID-19: Experiences from Qatar's Primary Care Settings.

作者信息

Syed Dr Mohamed Ahmed, Al Nuaimi Dr Ahmed Sameer

机构信息

Primary Health Care Corporation, P.O. Box 26555 Doha, Qatar.

出版信息

IJID Reg. 2022 Jun;3:138-142. doi: 10.1016/j.ijregi.2022.03.018. Epub 2022 Apr 4.

Abstract

OBJECTIVE

The aim of this paper is to establish the predictive ability of demographic and clinical factors in diagnosing Coronavirus Disease 2019 (COVID-19) in Qatar's publicly funded primary care settings.

METHODS

Reverse transcription polymerase chain reaction (rt-PCR) test and COVID-19 screening data (COVID-19 related factors) were extracted from electronic medical records for all individuals who visited a primary health care centre in Qatar between 15th March to 15th June 2020. Data analysis was undertaken to assess the validity of individual factors in predicting a positive rt-PCR test.

RESULTS

Fever/history of fever [N= 1471 (54.7%); OR 4.6 (95% CI 4.16 - 5.08)], followed by cough [N=1020 (37.9%); OR 1.82 (95% CI 1.65 - 2)] and headache [N=372 (13.8%); OR 1.45 (95% CI 1.27 - 1.67)] were the most frequently reported clinical symptoms amongst individuals who tested positive for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) infection by rt-PCR. Only five factors, fever/history of fever, cough, working/living in an area reporting local transmission, gender and headache (ranked according to predictive power), were found to be statistically significant. Fever/history of fever alone had a specificity of 79.2% and it gradually increased to 99.9% in combination with runny nose, cough, male gender and age ≥ 50.

CONCLUSIONS

The study identified predictive ability of factors in diagnosing COVID-19, individually and in combination. It proposes a scoring system for use in publicly funded primary care settings in Qatar without an rt-PCR test, thus enabling early isolation and treatment where necessary. Further similar studies are needed as newer variations of SARS-CoV2 are continuously emerging to ensure its accuracy.

摘要

目的

本文旨在确定卡塔尔公共资助基层医疗环境中人口统计学和临床因素对2019冠状病毒病(COVID-19)的诊断预测能力。

方法

从2020年3月15日至6月15日期间前往卡塔尔初级卫生保健中心就诊的所有个体的电子病历中提取逆转录聚合酶链反应(rt-PCR)检测结果和COVID-19筛查数据(与COVID-19相关的因素)。进行数据分析以评估个体因素对rt-PCR检测呈阳性的预测有效性。

结果

发热/发热史[N = 1471(54.7%);比值比(OR)4.6(95%置信区间[CI] 4.16 - 5.08)],其次是咳嗽[N = 1020(37.9%);OR 1.82(95% CI 1.65 - 2)]和头痛[N = 372(13.8%);OR 1.45(95% CI 1.27 - 1.67)]是通过rt-PCR检测严重急性呼吸综合征冠状病毒2(SARS-CoV2)感染呈阳性的个体中最常报告的临床症状。仅发现发热/发热史、咳嗽、在报告有本地传播的地区工作/生活、性别和头痛(按预测能力排序)这五个因素具有统计学意义。仅发热/发热史的特异性为79.2%,与流鼻涕、咳嗽、男性性别和年龄≥50岁相结合时,特异性逐渐增加到99.9%。

结论

该研究确定了个体因素及因素组合对COVID-19的诊断预测能力。它提出了一种评分系统,用于卡塔尔无rt-PCR检测的公共资助基层医疗环境,从而在必要时能够实现早期隔离和治疗。由于SARS-CoV2的新变种不断出现,需要进一步开展类似研究以确保其准确性。

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Diagnostics for SARS-CoV-2 infections.用于 SARS-CoV-2 感染的诊断方法。
Nat Mater. 2021 May;20(5):593-605. doi: 10.1038/s41563-020-00906-z. Epub 2021 Feb 15.
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Virological assessment of hospitalized patients with COVID-2019.住院 COVID-19 患者的病毒学评估。
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