Population-Based COVID-19 Screening in Mexico: Assessment of Symptoms and Their Weighting in Predicting SARS-CoV-2 Infection

Abstract

Background and Objectives: Sentinel surveillance in the early stage of the COVID-19 pandemic in Mexico represented a significant cost reduction and was useful in estimating the population infected with SARS-CoV-2. However, it also implied that many patients were not screened and therefore had no accurate diagnosis. In this study, we carried out a population-based SARS-CoV-2 screening in Mexico to evaluate the COVID-19-related symptoms and their weighting in predicting SARS-CoV-2 infection. We also discuss this data in the context of the operational definition of suspected cases of COVID-19 established by the Mexican Health Authority’s consensus. Materials and Methods: One thousand two hundred seventy-nine subjects were included. They were screened for SARS-CoV-2 using RT-PCR. The weighting of COVID-19 symptoms in predicting SARS-CoV-2 infection was evaluated statistically. Results: Three hundred and twenty-five patients were positive for SARS-CoV-2 and 954 were negative. Fever, asthenia, dysgeusia, and oxygen saturation predicted SARS-CoV-2 infection (odds ratios ranged from 1.74 to 4.98; p < 0.05). The percentage of asymptomatic COVID-19 patients was 36% and only 38.15% met the Mexican operational definition. Cq-values for the gene N of SARS-CoV-2 were significantly higher in asymptomatic subjects than in the groups of COVID-19 patients with neurological, respiratory, and/or musculoskeletal manifestations (p < 0.05). Conclusions: Dysgeusia, fever, and asthenia increased the odds of a positive result for COVID-19 1.74–4.98-fold among the study population. Patients with neurological, respiratory, and/or musculoskeletal manifestations had higher viral loads at COVID-19 diagnosis than those observed in asymptomatic patients. A high percentage of the participants in the study (61.85%) did not meet the operational definition for a suspected case of COVID-19 established by the Mexican Health Authority’s consensus, representing a high percentage of the population that could have remained without a COVID-19 diagnosis, so becoming a potential source of virus spread.

Autoimmune mediated hyperkinetic movement disorders in SARS-CoV-2 infection — a systematic review

“…The incidence of neurological symptoms varies significantly depending on the methodology used in the study (4.3-73.0%) [7]. In current reports, one of the most common neurological manifestations was headache (32.9-41.1%) and changes in taste and smell (18.8-36.8% and 18.2-37.9%) [8,9]. In the latter case, earlier reports indicated a much higher frequency (88.0% and 85.6%) [10].…”

COVID-19 cases, hospitalizations, outpatients, and deaths in Mexico by ethnicity and state-level income

“…At the outset of the pandemic in Mexico, a suspected COVID-19 case was one where in the previous 7 days, the patient presented at least two of the following: cough, fever, headache, and one or more of either dyspnea, arthralgia, myalgia, odynophagia, rhinorrhea, conjunctivitis, or chest pain. This definition was updated on August 24, 2020, and COVID-19 was suspected when in the previous 10 days, the patient presented one or more of the following: cough, fever, dyspnea, headache, and one or more of either arthralgia, myalgia, odynophagia, chills, rhinorrhea, conjunctivitis, chest pain, anosmia, or dysgeusia [34]. Additionally, the higher proportion of indigenous patients in this situation might indicate a language barrier, where the symptoms of the indigenous patient are not clearly understood by the attending health professional, since 12.3% of the indigenous population that speaks an indigenous language are monolingual [17].…”

Exploring the Clinical Utility of Gustatory Dysfunction (GD) as a Triage Symptom Prior to Reverse Transcription Polymerase Chain Reaction (RT-PCR) in the Diagnosis of COVID-19: A Meta-Analysis and Systematic Review

“…Alizadehsani [142] Altman [143] Beltrán-Corbellini [176] Bénézit [34] Bidkar [139] Boudjema [140] Carignan [177] Chas [144] Chen [149] Cho [178] Dawson [179] Dixon [180] Dreyer [150] Elimian [181] Fistera [145] Ganz-Lord [146] Gibbons [151] Gurrola [182] Izquierdo-Domínguez [183] Jeyashree (1) [141] Jeyashree (2) [141] Karni [152] Kempker [184] La Torre [185] Leal [186] Lee [187] Martin-Sanz [188] Martinez-Fierro [189] Moeller [147] Moolla [190] Nakanishi [191] Pérula de Torres [192] Raberahona [148] Riestra-Ayora [193] Rojas-Lechuga [194] Sayin [195] Sbrana [153] Sonoda [196] Trachootham [197] Trubiano [198] Tudrej [199] Villerabel [200] Yan [201] Zayet (1) [202] Zayet (2) [203] Appendix D Specify the methods ...…”