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Predictive Value of Isolated Symptoms for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children Tested During Peak Circulation of the Delta Variant.
- Source :
-
Clinical Infectious Diseases . 10/1/2022, Vol. 75 Issue 7, p1131-1139. 9p. - Publication Year :
- 2022
-
Abstract
- Background Coronavirus disease 2019 (COVID-19) testing policies for symptomatic children attending US schools or daycare vary, and whether isolated symptoms should prompt testing is unclear. We evaluated children presenting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing to determine if the likelihood of having a positive SARS-CoV-2 test differed between participants with 1 symptom vs ≥2 symptoms, and to examine the predictive capability of isolated symptoms. Methods Participants aged < 18 years presenting for clinical SARS-CoV-2 molecular testing in 6 sites in urban/suburban/rural Georgia (July–October, 2021; Delta variant predominant) were queried about individual symptoms. Participants were classified into 3 groups: asymptomatic, 1 symptom only, or ≥2 symptoms. SARS-CoV-2 test results and clinical characteristics of the 3 groups were compared. Sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) for isolated symptoms were calculated by fitting a saturated Poisson model. Results Of 602 participants, 21.8% tested positive and 48.7% had a known or suspected close contact. Children reporting 1 symptom (n = 82; odds ratio [OR], 6.00 [95% confidence interval {CI}, 2.70–13.33]) and children reporting ≥2 symptoms (n = 365; OR, 5.25 [95% CI, 2.66–10.38]) were significantly more likely to have a positive COVID-19 test than asymptomatic children (n = 155), but they were not significantly different from each other (OR, 0.88 [95% CI,.52–1.49]). Sensitivity and PPV were highest for isolated fever (33% and 57%, respectively), cough (25% and 32%), and sore throat (21% and 45%); headache had low sensitivity (8%) but higher PPV (33%). Sensitivity and PPV of isolated congestion/rhinorrhea were 8% and 9%, respectively. Conclusions With high Delta variant prevalence, children with isolated symptoms were as likely as those with multiple symptoms to test positive for COVID-19. Isolated fever, cough, sore throat, or headache, but not congestion/rhinorrhea, offered the highest predictive value. [ABSTRACT FROM AUTHOR]
- Subjects :
- *COVID-19
*PREDICTIVE tests
*GENETIC mutation
*MOLECULAR diagnosis
*CONFIDENCE intervals
*FEVER
*RURAL conditions
*RHINORRHEA
*SYMPTOMS
*DESCRIPTIVE statistics
*COUGH
*COVID-19 testing
*METROPOLITAN areas
*SENSITIVITY & specificity (Statistics)
*ODDS ratio
*HEADACHE
*ISOLATION (Hospital care)
*POISSON distribution
*PHARYNGITIS
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 75
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 159478652
- Full Text :
- https://doi.org/10.1093/cid/ciac112