Final published version, 1.75 MB, fulltext
Available under license: CC BY: Creative Commons Attribution 4.0 International License
Final published version
Licence: CC BY: Creative Commons Attribution 4.0 International License
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Symptom profiles and accuracy of clinical case definitions for COVID-19 in a community cohort
T2 - results from the Virus Watch study
AU - Fragaszy, Ellen
AU - Shrotri, Madhumita
AU - Geismar, Cyril
AU - Aryee, Anna
AU - Beale, Sarah
AU - Braithwaite, Isobel
AU - Byrne, Thomas
AU - Eyre, Max T
AU - Fong, Wing Lam Erica
AU - Gibbs, Jo
AU - Hardelid, Pia
AU - Kovar, Jana
AU - Lampos, Vasileios
AU - Nastouli, Eleni
AU - Navaratnam, Annalan M D
AU - Nguyen, Vincent
AU - Patel, Parth
AU - Aldridge, Robert W
AU - Hayward, Andrew
PY - 2022/3/10
Y1 - 2022/3/10
N2 - Background: Understanding symptomatology and accuracy of clinical case definitions for community COVID-19 cases is important for Test, Trace and Isolate (TTI) and future targeting of early antiviral treatment. Methods: Community cohort participants prospectively recorded daily symptoms and swab results (mainly undertaken through the UK TTI system). We compared symptom frequency, severity, timing, and duration in test positive and negative illnesses. We compared the test performance of the current UK TTI case definition (cough, high temperature, or loss of or altered sense of smell or taste) with a wider definition adding muscle aches, chills, headache, or loss of appetite. Results: Among 9706 swabbed illnesses, including 973 SARS-CoV-2 positives, symptoms were more common, severe and longer lasting in swab positive than negative illnesses. Cough, headache, fatigue, and muscle aches were the most common symptoms in positive illnesses but also common in negative illnesses. Conversely, high temperature, loss or altered sense of smell or taste and loss of appetite were less frequent in positive illnesses, but comparatively even less frequent in negative illnesses. The current UK definition had 81% sensitivity and 47% specificity versus 93% and 27% respectively for the broader definition. 1.7-fold more illnesses met the broader case definition than the current definition. Conclusions: Symptoms alone cannot reliably distinguish COVID-19 from other respiratory illnesses. Adding additional symptoms to case definitions could identify more infections, but with a large increase in the number needing testing and the number of unwell individuals and contacts self-isolating whilst awaiting results.
AB - Background: Understanding symptomatology and accuracy of clinical case definitions for community COVID-19 cases is important for Test, Trace and Isolate (TTI) and future targeting of early antiviral treatment. Methods: Community cohort participants prospectively recorded daily symptoms and swab results (mainly undertaken through the UK TTI system). We compared symptom frequency, severity, timing, and duration in test positive and negative illnesses. We compared the test performance of the current UK TTI case definition (cough, high temperature, or loss of or altered sense of smell or taste) with a wider definition adding muscle aches, chills, headache, or loss of appetite. Results: Among 9706 swabbed illnesses, including 973 SARS-CoV-2 positives, symptoms were more common, severe and longer lasting in swab positive than negative illnesses. Cough, headache, fatigue, and muscle aches were the most common symptoms in positive illnesses but also common in negative illnesses. Conversely, high temperature, loss or altered sense of smell or taste and loss of appetite were less frequent in positive illnesses, but comparatively even less frequent in negative illnesses. The current UK definition had 81% sensitivity and 47% specificity versus 93% and 27% respectively for the broader definition. 1.7-fold more illnesses met the broader case definition than the current definition. Conclusions: Symptoms alone cannot reliably distinguish COVID-19 from other respiratory illnesses. Adding additional symptoms to case definitions could identify more infections, but with a large increase in the number needing testing and the number of unwell individuals and contacts self-isolating whilst awaiting results.
KW - Symptoms
KW - Clinical Case Definitions
KW - Covid-19
U2 - 10.12688/wellcomeopenres.17479.1
DO - 10.12688/wellcomeopenres.17479.1
M3 - Journal article
VL - 7
JO - Wellcome Open Research
JF - Wellcome Open Research
SN - 2398-502X
M1 - 84
ER -