Repositorio
Institucional

Martinez, Felipe

Munoz, Sergio

Guerrero-Nancuante, Camilo

Taramasco, Carla

Sensitivity and Specificity of Patient-Reported Clinical Manifestations to Diagnose COVID-19 in Adults from a National Database in Chile: A Cross-Sectional Study

MDPI

BIOLOGY-BASEL

en

Simple Summary COVID-19 is frequently suspected based on clinical features, such as fever, cough, headache, or loss of taste. However, it remains unclear whether these manifestations are reliable indicators of disease. We sought to evaluate the diagnostic accuracy of clinical manifestations in identifying patients with COVID-19. Data from a nationwide database comprising of 2,187,962 patients who sought medical care in Chile were analysed. Information regarding age, gender, type of insurance, a history of a close contact with COVID-19, and several clinical features was obtained. The most common complaints were headache, muscle aches, and cough. No single clinical feature was precise enough to fully confirm or exclude COVID-19. The combination of several of these manifestations with epidemiological risk factors into a model showed a reasonable accuracy in detecting cases of COVID-19. (1) Background: The diagnosis of COVID-19 is frequently made on the basis of a suggestive clinical history and the detection of SARS-CoV-2 RNA in respiratory secretions. However, the diagnostic accuracy of clinical features is unknown. (2) Objective: To assess the diagnostic accuracy of patient-reported clinical manifestations to identify cases of COVID-19. (3) Methodology: Cross-sectional study using data from a national registry in Chile. Infection by SARS-CoV-2 was confirmed using RT-PCR in all cases. Anonymised information regarding demographic characteristics and clinical features were assessed using sensitivity, specificity, and diagnostic odds ratios. A multivariable logistic regression model was constructed to combine epidemiological risk factors and clinical features. (4) Results: A total of 2,187,962 observations were available for analyses. Male participants had a mean age of 43.1 +/- 17.5 years. The most common complaints within the study were headache (39%), myalgia (32.7%), cough (31.6%), and sore throat (25.7%). The most sensitive features of disease were headache, myalgia, and cough, and the most specific were anosmia and dysgeusia/ageusia. A multivariable model showed a fair diagnostic accuracy, with a ROC AUC of 0.744 (95% CI 0.743-0.746). (5) Discussion: No single clinical feature was able to fully confirm or exclude an infection by SARS-CoV-2. The combination of several demographic and clinical factors had a fair diagnostic accuracy in identifying patients with the disease. This model can help clinicians tailor the probability of COVID-19 and select diagnostic tests appropriate to their setting.

artículo original

This work was funded by the Chilean Agencia Nacional de Investigacion y Desarrollo (ANID). Project COVID0739 and Millennium Science Initiative NCS2021_013. The funding source did not have any role in the study's design, conduct, or reporting.

Este trabajo fue financiado por la Agencia Nacional de Investigación y Desarrollo (ANID) de Chile. Proyecto COVID0739 e Iniciativa Científica del Milenio NCS2021_013. La fuente de financiación no tuvo ningún papel en el diseño, la realización o la presentación de informes del estudio.

10.3390/biology11081136

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COVID-19

clinical manifestations

diagnostic accuracy

risk factors

Biología

COVID-19

manifestaciones clínicas

precisión diagnóstica

factores de riesgo

Enfermedades Infecciosas

Epidemiología

Medicina General e Interna

Sensitivity and Specificity of Patient-Reported Clinical Manifestations to Diagnose COVID-19 in Adults from a National Database in Chile: A Cross-Sectional Study

artículo original

version publicada

CC BY 4.0

CC BY 4.0

acceso abierto

acceso abierto

ANID COVID0739

ANID NCS2021_013

WOS:000847104200001