COVID-19 symptoms: a case–control study, Portugal, March–April 2020

Abstract

COVID-19, although a respiratory illness, has been clinically associated with non-respiratory symptoms. We conducted a negative case–control study to identify the symptoms associated with SARS-CoV-2-positive results in Portugal. Twelve symptoms and signs included in the clinical notification of COVID-19 were selected as predictors, and the dependent variable was the RT-PCR test result. The χ2 tests were used to compare notified cases on sex, age group, health region and presence of comorbidities. The best-fit prediction model was selected using a backward stepwise method with an unconditional logistic regression. General and gastrointestinal symptoms were strongly associated with a positive test (P < 0.001). In this sense, the inclusion of general symptoms such as myalgia, headache and fatigue, as well as diarrhoea, together with actual clinical criteria for suspected cases, already updated and included in COVID-19 case definition, can lead to increased identification of cases and represent an effective strength for transmission control.

Covid-19 Hastalarında Başvuru Şikayetleri

“…It is necessary to establish a reliable method for COVID-19 patients to distinguish patients who may have critical symptoms from other patients. In a study where the diagnostic power of disease symptoms was evaluated, 11442 of 51726 COVID-19 suspect case reports had sufficient symptom data for analysis, and 16% of them were tested positive for COVID-19 (28). Among the test positive cases, cough (73%), fever (60%), myalgia (44%), headache (40%) and fatigue (38%) were the most frequently reported symptoms.…”

“…This rate was lower for cough, but not significant for shortness of breath. In the developed multivariate model, the presence of fever, myalgia, headache, fatigue or diarrhea was strongly associated with the result of the positive COVID-19 test result, the presence of cough or sore throat was found to be negatively correlated with diarrhea (28). In our study, presenting complaints were analyzed for the discriminatory characteristics for the disease, and fever, loss of appetite, cough, loss of sense of smell and loss of strength were found significant for PCR positivity.…”

Gut distress and intervention via communications of SARS-CoV-2 with mucosal exposome

“…In study ID 3, the pooled OR was 1.28 (95% Cl: 0.30–5.48), with a weight of 9.65% ( 14 ). In study ID 4, the pooled OR was 1.67 (95% Cl: 1.45–1.93) with a weight of 16.66% ( 15 ). In study ID 5, the pooled OR was 0.96 (95% Cl: 0.54–1.72), with a weight of 15.33% ( 16 ).…”

“…Study ID 3 was not included (14). In study ID 4, the pooled OR was 1.17 (95% Cl: 0.96-1.42) with a weight of 32.80% (15). Study IDs 5 and 6 were not included in this analysis (16,19).…”

Main changes in the “COVID-19 in paediatrics” clinical practice guideline

“…As regards the predictive value of clinical features, there is evidence of associations that, with the exception of anosmia and ageusia, are very nonspecific. 16 The best combination to predict COVID-19 continues to be the one described in the first version of the guideline, consisting of headache, nausea/vomiting and anosmia/ageusia (positive likelihood ratio, 65.92; 95% CI, 49.48 to 91.92). As regards risk factors, age less than 6 months is associated with more severe disease (OR, 2.54; 95% CI, 1.08 to 5.98), as is the presence of underlying chronic disease, chiefly neurologic disorders (OR, 5.16; 95% CI, 2.30 to 11.60) and obesity (OR, 2.54; 95% CI, 1.08 to 5.98).…”