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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.

Authors :
Westbrook, Adrianna L
Benedit, Laura C
Frediani, Jennifer K
Griffiths, Mark A
Khan, Nabeel Y
Levy, Joshua M
Morris, Claudia R
Rostad, Christina A
Stone, Cheryl L
Sullivan, Julie
Vos, Miriam B
Welsh, Jean
Wood, Anna
Martin, Greg S
Lam, Wilbur
Pollock, Nira R
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]

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