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Development of a diagnostic multivariable prediction model of a positive SARS-CoV-2 RT-PCR result in healthcare workers with suspected SARS-CoV-2 infection in hospital settings.

作者信息

Valderrama-Beltrán Sandra Liliana, Cuervo-Rojas Juliana, Rondón Martín, Montealegre-Diaz Juan Sebastián, Vera Juan David, Martinez-Vernaza Samuel, Bonilla Alejandra, Molineros Camilo, Fierro Viviana, Moreno Atilio, Villalobos Leidy, Ariza Beatriz, Álvarez-Moreno Carlos

机构信息

Faculty of Medicine, Department of Clinical Epidemiology and Biostatistics, PhD Program in Clinical Epidemiology, Pontificia Universidad Javeriana, Bogotá, Colombia.

Faculty of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Infectious Diseases Research Group, Bogotá, Colombia.

出版信息

PLoS One. 2024 Dec 26;19(12):e0316207. doi: 10.1371/journal.pone.0316207. eCollection 2024.


DOI:10.1371/journal.pone.0316207
PMID:39724211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11670996/
Abstract

BACKGROUND: Despite declining COVID-19 incidence, healthcare workers (HCWs) still face an elevated risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. We developed a diagnostic multivariate model to predict positive reverse transcription polymerase chain reaction (RT-PCR) results in HCWs with suspected SARS-CoV-2 infection. METHODS: We conducted a cross-sectional study on episodes involving suspected SARS-CoV-2 symptoms or close contact among HCWs in Bogotá, Colombia. Potential predictors were chosen based on clinical relevance, expert knowledge, and literature review. Logistic regression was used, and the best model was selected by evaluating model fit with Akaike Information Criterion (AIC), deviance, and maximum likelihood. RESULTS: The study included 2498 episodes occurring between March 6, 2020, to February 2, 2022. The selected variables were age, socioeconomic status, occupation, service, symptoms (fever, cough, fatigue/weakness, diarrhea, anosmia or dysgeusia), asthma, history of SARS-CoV-2, vaccination status, and population-level RT-PCR positivity. The model achieved an AUC of 0.79 (95% CI 0.77-0.81), with 93% specificity, 36% sensitivity, and satisfactory calibration. CONCLUSIONS: We present an innovative diagnostic prediction model that as a special feature includes a variable that represents SARS-CoV-2 epidemiological situation. Given its performance, we suggest using the model differently based on the level of viral circulation in the population. In low SARS-CoV-2 circulation periods, the model could serve as a replacement diagnostic test to classify HCWs as infected or not, potentially reducing the need for RT-PCR. Conversely, in high viral circulation periods, the model could be used as a triage test due to its high specificity. If the model predicts a high probability of a positive RT-PCR result, the HCW may be considered infected, and no further testing is performed. If the model indicates a low probability, the HCW should undergo a COVID-19 test. In resource-limited settings, this model can help prioritize testing and reduce expenses.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab94/11670996/1c731184e776/pone.0316207.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab94/11670996/c86eb8ef101f/pone.0316207.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab94/11670996/09decfd14a84/pone.0316207.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab94/11670996/1c731184e776/pone.0316207.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab94/11670996/c86eb8ef101f/pone.0316207.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab94/11670996/09decfd14a84/pone.0316207.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab94/11670996/1c731184e776/pone.0316207.g003.jpg

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Development of a diagnostic multivariable prediction model of a positive SARS-CoV-2 RT-PCR result in healthcare workers with suspected SARS-CoV-2 infection in hospital settings.

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本文引用的文献

[1]
Relative vaccine protection, disease severity, and symptoms associated with the SARS-CoV-2 omicron subvariant BA.2.86 and descendant JN.1 in Denmark: a nationwide observational study.

Lancet Infect Dis. 2024-9

[2]
Should automated electronic hand-hygiene monitoring systems be implemented in routine patient care? Systematic review and appraisal with Medical Research Council Framework for Complex Interventions.

J Hosp Infect. 2024-5

[3]
As COVID-19 Cases Surge, Here's What to Know About JN.1, the Latest SARS-CoV-2 "Variant of Interest".

JAMA. 2024-2-6

[4]
A Danish questionnaire study of acute symptoms of SARS-CoV-2 infection by variant, vaccination status, sex and age.

Sci Rep. 2023-11-14

[5]
The burden and dynamics of hospital-acquired SARS-CoV-2 in England.

Nature. 2023-11

[6]
Assessment of the Risk and Symptoms of SARS-CoV-2 Infection Among Healthcare Workers During the Omicron Transmission Period: A Multicentric Study from Four Hospitals of Mainland China.

Infect Drug Resist. 2023-5-29

[7]
Clinical features of Omicron variant infection in 445 patients with coronavirus 19 disease.

Ann Saudi Med. 2023

[8]
Diagnostic accuracy of a set of clinical and radiological criteria for screening of COVID-19 using RT-PCR as the reference standard.

BMC Pulm Med. 2023-3-9

[9]
Comparison of clinician diagnosis of COVID-19 with real time polymerase chain reaction in an adult-representative population in Sweden.

Respir Res. 2023-1-11

[10]
SARS-CoV-2 neutralizing antibody response in vaccinated and non-vaccinated hospital healthcare workers with or without history of infection.

Microbes Infect. 2023

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