Predictors of SARS-CoV-2 Positivity Based on RT-PCR Swab Tests at a Drive-Through Outpatient Clinic for COVID-19 Screening in Japan
Predictors of SARS-CoV-2 Positivity Based on RT-PCR Swab Tests at a Drive-Through Outpatient Clinic for COVID-19 Screening in Japan
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DOI：
10.1620/tjem.253.101
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发表时间：
2021-02-01
影响因子：
2.2
通讯作者：
Akaishi, Tetsuya
中科院分区：
文献类型：
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作者：
Ishii, Tadashi;Kushimoto, Shigeki;Akaishi, Tetsuya
为了应对 2020 年由 SARS-CoV-2 引起的 COVID-19 大流行，我们自 2020 年 4 月起在日本仙台市进行了 COVID-19 免下车鼻咽拭子检测。所有受检测者均由公共卫生中心提前判断是否有必要接受检测，且可能有接触史和/或暗示有 COVID-19 的症状。在这项研究中，为了确定 SARS-CoV-2 检测阳性的预测因素，以便更有效、更有依据地选择疑似个体，我们连续招募了 3,540 名个体，在测试计划的前 7 个月内进行了检测，并提供了与 COVID-19 患者（包括参与聚集性疫情的患者）密切接触史的数据。该群体包括来自一所职业学校的 284 名外国学生（257 名男性和 27 名女性），该学校卷入了该地区最大规模的聚集性疫情。 952 名（26.9%）的参与者有密切接触史。逆转录聚合酶链反应（RT-PCR）检测结果显示，164 名参与者（4.6%）的 SARS-CoV-2 核衣壳基因（N2）呈阳性，3,376 名参与者（95.4%）呈阴性。在单变量和多变量分析中，与 COVID-19 患者的密切接触史、较高年龄、咳嗽症状和非本地种族是 SARS-CoV-2 检测呈阳性的预测因素。然而，当将外国学生排除在上述最大的聚集性疫情之外时，年龄和外国国籍的重要性就消失或下降了。总之，与 COVID-19 患者的密切接触史和咳嗽症状的存在是 SARS-CoV-2 检测呈阳性的重要预测因素。
In response to the COVID-19 pandemic caused by SARS-CoV-2 in 2020, we conducted drive-through nasopharyngeal swab testing for COVID-19 in Sendai city, Japan, since April 2020. All tested individuals were judged in advance by public health centers for the necessity of undergoing the test with possible contact history and/or symptoms suggestive of COVID-19. In this study, to identify the predictors of SARS-CoV-2 test positivity for more efficient and evidenced selection of suspected individuals, we enrolled 3,540 consecutive individuals, tested in the first 7 months of the testing program, with data regarding to the history of close contact with COVID-19 patients, including those involved in cluster outbreaks. This cohort included 284 foreign students (257 males and 27 females) from a vocational school involved in the largest cluster outbreak in the area. Close contact history was present in 952 (26.9%) of the participants. The reverse transcription-polymerase chain reaction (RT-PCR) test results showed that 164 participants (4.6%) were positive and 3,376 participants (95.4%) were negative for the SARS-CoV-2 nucleocapsid gene (N2). In the univariate and multivariate analyses, history of close contact with COVID-19 patients, higher age, cough symptoms, and non-native ethnicity were predictors for SARS-CoV-2 test positivity. However, the significance of age and foreign nationality disappeared or declined upon excluding the foreign students from the aforementioned largest cluster outbreak. In conclusion, a history of close contact with COVID-19 patients and the presence of cough symptoms are significant predictors of SARS-CoV-2 test positivity.