Clinical and epidemiological characteristics of patients seeking COVID-19 testing in a private centre in Malaysia: Is there a role for private healthcare in battling the outbreak?

Abstract

Objective This cross-sectional observational study summarized the baseline characteristics of subjects who underwent COVID-19 molecular testing in a private medical centre located in the state of Selangor in Malaysia between 1 Oct 2020 and 31 Jan 2021. We compared the baseline characteristics between subjects who were tested positive and negative of SARS-CoV-2 infection, and identified risk factors which may be predictive of SARS-CoV-2 positivity. Methods and findings A total of 36603 subjects who were tested for COVID-19 infection via molecular assays at Sunway Medical Centre between Oct 1, 2020 and Jan 31, 2021, and consented to participate in this observation study were included for analysis. Descriptive statistics was used to summarize the study cohort, whereas logistic regression analysis was used to identify risk factors associated with SARS-CoV-2 positivity. Among the reasons listed for COVID-19 screening were those who needed clearance for travelling, clearance to return to work, or clearance prior to hospital admission. They accounted for 67.7% of tested subjects, followed by the self-referred group (27.3%). Most of the confirmed cases were asymptomatic (62.6%), had no travel history (99.6%), and had neither exposure to SARS-CoV-2 confirmed cases (61.9%) nor exposure to patients under investigation (82.7%) and disease clusters (89.2%). Those who presented with loss of smell or taste (OR: 26.91; 95% CI: 14.81–48.92, p<0.001), fever (OR:3.97; 95% CI: 2.54–6.20, p<0.001), running nose (OR: 1.75; 95% CI:1.10–2.79, p = 0.019) or other symptoms (OR: 5.63; 95% CI:1.68–18.91, p = 0.005) were significantly associated with SARS-CoV-2 positivity in the multivariate logistic regression analysis. Conclusion Our study showed that majority of patients seeking COVID-19 testing in a private healthcare setting were mainly asymptomatic with low epidemiological risk. Consequently, the average positivity rate was 1.2% compared to the national cumulative positivity rate of 4.65%. Consistent with other studies, we found that loss of smell or taste, fever and running nose were associated with SARS-CoV-2 positivity. We believe that strengthening the capacity of private health institutions is important in the national battle against the COVID-19 pandemic, emphasizing the importance of public-private partnership to improve the quality of clinical care.

Initial Signs and Symptoms in Suspected Patients Admitted to Triage Outpatient Clinic of Coronavirus Disease 2019 (COVID-19): A Single-Center Experience

“…(6.2% to 24.1%) (11,18). A study carried out in Malaysia showed that presentation with high fever increased almost 4-fold of having PCR (+) test results (21). In our study, the incidence of fever in patients diagnosed with COVID-19 was significantly higher than in COVID (-) cases (35.3% vs. 20.4%).…”

“…In a retrospective New York study, the most common symptoms were described as fever, coughing, shortness of breath, muscle pain, and, nausea respectively (20). In a study carried out in Malaysia, though most of the confirmed cases were asymptomatic, those who presented with loss of smell/taste, fever, running nose were significantly associated with positivity due to the multivariate logistic regression analysis (21). Sahin et al revealed odd's rates of significant complaints about PCR positivity were 2.607 for fever, 2.724 for anorexia, 2.051 for cough, 2.594 for loss of smell, and 2.243 for loss of strength (6).…”

More than a Tripledemic: Influenza A Virus, Respiratory Syncytial Virus, SARS-CoV-2, and Human Metapneumovirus in Wastewater during Winter 2022–2023

“…We find that the co-occurrence of the onset of these outbreaks is identifiable using wastewater monitoring, and moreover, HMPV was also circulating. Whereas clinical testing data are affected by individuals’ test seeking behaviors and test availability, − as well as institutional reporting delays which can be weeks in duration, , wastewater data are available within 24 h of sample collection and provide information about the entire community contributing to the wastewater system. We posit that wastewater can be used to help identify the onset and offset of respiratory virus transmission events as well as the peak of such events.…”