El Ghiadi Amira, Eddali Omnia, Ashur Sana, Sabei Laila
Primary Health Care Institution, Ministry of Health, Tripoli, Libya.
Department of Family and Community Medicine, Faculty of Medicine, University of Tripoli, Tripoli, Libya.
East Mediterr Health J. 2022 Sep 29;28(9):664-672. doi: 10.26719/emhj.22.061.
COVID-19 has symptoms similar to several other respiratory and non-respiratory diseases, which makes differentiating them a challenging task and could lead to unnecessary use of realtime reverse transcriptase polymerase chain reaction (RT-PCR) resources.
The study aimed to assess self-reported symptoms as predictors for RT-PCR positivity in suspected COVID-19 cases.
This was a cross-sectional study. We retrospectively reviewed the database of COVID-19 care centres in the eastern district of Tripoli, Libya, from May to December 2020. Presenting symptoms and RT-PCR test data were extracted.
Of the 4593 subjects, 923 (20.1%) had positive RT-PCR result. Sensitivity for COVID-19 disease diagnosis was very low (≤ 18.2%) for all symptoms, except for myalgia (82.1%). Specificity was high for all symptoms (90.7-99.8%), except for myalgia (11.0%). Loss of taste and smell had the highest positive likelihood ratio (LR) for RT-PCR positivity (LR+ = 3.59, 95% CI: 2.95-4.37). In the multiple logistic regression, three symptoms maintained significant contribution to RT-PCR positivity; these were loss of taste and smell (odds ratio (OR) = 3.90, 95% CI: 3.04-4.99), sore throat (OR = 1.50, 95% CI: 1.02-2.19), and myalgia (OR = 0.65, 95% CI: 0.49-0.85). Other significant predictors were history of contact with a COVID-19 case (OR = 0.50, 95% CI: 0.39-0.62), and being female (OR = 1.33, 95% CI: 1.15-1.55).
The findings of this study do not support the use of self-reported symptoms for the confirmation of COVID-19 disease in suspected cases because of their poor diagnostic properties.
新型冠状病毒肺炎（COVID-19）的症状与其他几种呼吸道和非呼吸道疾病相似，这使得区分它们成为一项具有挑战性的任务，并可能导致实时逆转录聚合酶链反应（RT-PCR）资源的不必要使用。
本研究旨在评估自我报告的症状作为疑似COVID-19病例中RT-PCR阳性的预测指标。
这是一项横断面研究。我们回顾性分析了2020年5月至12月利比亚的黎波里东区COVID-19护理中心的数据库。提取了出现的症状和RT-PCR检测数据。
在4593名受试者中，923人（20.1%）RT-PCR结果呈阳性。除肌痛（82.1%）外，所有症状对COVID-19疾病诊断的敏感性都很低（≤18.2%）。除肌痛（11.0%）外，所有症状的特异性都很高（90.7 - 99.8%）。味觉和嗅觉丧失对RT-PCR阳性具有最高的阳性似然比（LR）（LR+ = 3.59，95%CI：2.95 - 4.37）。在多元逻辑回归中，三种症状对RT-PCR阳性仍有显著贡献；这些症状是味觉和嗅觉丧失（比值比（OR） = 3.90，95%CI：3.04 - 4.99）、喉咙痛（OR = 1.50，95%CI：1.02 - 2.19）和肌痛（OR = 0.65，95%CI：0.49 - 0.85）。其他显著的预测因素是与COVID-19病例接触史（OR = 0.50，95%CI：0.39 - 0.62）和女性（OR = 1.33，95%CI：1.15 - 1.55）。
由于自我报告症状的诊断性能较差，本研究结果不支持在疑似病例中使用自我报告症状来确诊COVID-19疾病。
