Department of Internal Medicine, Sasebo Memorial Hospital, Sasebo, Nagasaki, 858-0922, Japan.
Sasebo city medical association, Sasebo, Nagasaki, 857-0801, Japan.
Virol J. 2024 May 14;21(1):111. doi: 10.1186/s12985-024-02388-w.
Demand for COVID-19 testing prompted the implementation of drive-through testing systems. However, limited research has examined factors influencing testing positivity in this setting.
From October 2020 to March 2023, a total of 1,341 patients, along with their clinical information, were referred from local clinics to the Sasebo City COVID-19 drive-through PCR center for testing. Association between clinical information or factors related to the drive-through center and testing results was analyzed by Fisher's exact test and logistic regression models.
Individuals testing positive exhibited higher frequencies of upper respiratory symptoms; cough (OR 1.5 (95% CI 1.2-1.8), p < 0.001, q = 0.005), sore throat (OR 2.4 (95% CI 1.9-3.0), p < 0.001, q < 0.001), runny nose (OR 1.4 (95% CI 1.1-1.8), p = 0.002, q = 0.009), and systemic symptoms; fever (OR 1.5 (95% CI 1.1-2.0), p = 0.006, q = 0.02), headache (OR 1.9 (95% CI 1.4-2.5), p < 0.001, q < 0.001), and joint pain (OR 2.7 (95% CI 1.8-4.1), p < 0.001, q < 0.001). Conversely, gastrointestinal symptoms; diarrhea (OR 0.2 (95% CI 0.1-0.4), p < 0.001, q < 0.001) and nausea (OR 0.3 (95% CI 0.1-0.6), p < 0.001, q < 0.001) were less prevalent among positives. During omicron strain predominant period, higher testing positivity rate (OR 20 (95% CI 13-31), p < 0.001) and shorter period from symptom onset to testing (3.2 vs. 6.0 days, p < 0.001) were observed compared to pre-omicron period. Besides symptoms, contact history with infected persons at home (OR 4.5 (95% CI 3.1-6.5), p < 0.001, q < 0.001) and in office or school (OR 2.9 (95% CI 2.1-4.1), p < 0.001, q < 0.001), as well as the number of sample collection experiences by collectors (B 7.2 (95% CI 2.8-12), p = 0.002) were also associated with testing results.
These findings underscore the importance of factors related to drive-through centers, especially contact history interviews and sample collection skills, for achieving higher rates of COVID-19 testing positivity. They also contribute to enhanced preparedness for next infectious disease pandemics.
对 COVID-19 检测的需求促使了免下车检测系统的实施。然而，在这种环境下，对影响检测阳性率的因素的研究还很有限。
从 2020 年 10 月至 2023 年 3 月，共有 1341 名患者及其临床信息从当地诊所被转介到佐世保市的 COVID-19 免下车 PCR 中心进行检测。通过 Fisher 精确检验和逻辑回归模型分析了临床信息或与免下车中心相关的因素与检测结果之间的关联。
检测呈阳性的个体表现出更高频率的上呼吸道症状；咳嗽（OR 1.5（95%CI 1.2-1.8），p<0.001，q=0.005）、喉咙痛（OR 2.4（95%CI 1.9-3.0），p<0.001，q<0.001）、流鼻涕（OR 1.4（95%CI 1.1-1.8），p=0.002，q=0.009）和全身症状；发热（OR 1.5（95%CI 1.1-2.0），p=0.006，q=0.02）、头痛（OR 1.9（95%CI 1.4-2.5），p<0.001，q<0.001）和关节痛（OR 2.7（95%CI 1.8-4.1），p<0.001，q<0.001）。相反，阳性患者胃肠道症状；腹泻（OR 0.2（95%CI 0.1-0.4），p<0.001，q<0.001）和恶心（OR 0.3（95%CI 0.1-0.6），p<0.001，q<0.001）的发生率较低。在 omicron 株占主导地位的时期，与 omicron 株出现前相比，阳性率更高（OR 20（95%CI 13-31），p<0.001），且从症状出现到检测的时间更短（3.2 天 vs. 6.0 天，p<0.001）。除症状外，与家中感染者（OR 4.5（95%CI 3.1-6.5），p<0.001，q<0.001）和办公室或学校（OR 2.9（95%CI 2.1-4.1），p<0.001，q<0.001）的接触史，以及采集者的样本采集经验次数（B 7.2（95%CI 2.8-12），p=0.002）也与检测结果相关。
这些发现强调了与免下车中心相关的因素的重要性，特别是接触史访谈和样本采集技能，以实现更高的 COVID-19 检测阳性率。它们还为下一次传染病大流行做好了准备。
