Rapid COVID-19 Screening Based on Self-Reported Symptoms: Psychometric Assessment and Validation of the EPICOVID19 Short Diagnostic Scale.
Rapid COVID-19 Screening Based on Self-Reported Symptoms: Psychometric Assessment and Validation of the EPICOVID19 Short Diagnostic Scale.
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DOI：
10.2196/23897
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发表时间：
2021-01-06
影响因子：
7.4
通讯作者：
Molinaro S
中科院分区：
文献类型：
--
作者：
Bastiani L;Fortunato L;Pieroni S;Bianchi F;Adorni F;Prinelli F;Giacomelli A;Pagani G;Maggi S;Trevisan C;Noale M;Jesuthasan N;Sojic A;Pettenati C;Andreoni M;Antonelli Incalzi R;Galli M;Molinaro S
已有200多个国家登记了新冠肺炎确诊病例，截至2020年7月28日，向世界卫生组织报告的病例超过1600万例。本研究是在意大利COVID-19流行高峰期间进行的。及早发现疑似COVID-19患者对于立即隔离这些人至关重要。尽管调查被广泛用于确定COVID-19病例、结果和相关风险，但没有经过验证的流行病学工具用于调查普通人群中的SARS-CoV-2感染情况。我们评估了自我报告症状在区分COVID-19方面的能力，以确定需要进行仪器测量的个体。我们定义并验证了一种识别分界点的方法。我们的研究是EPICOVID19意大利全国调查的第二阶段，该调查于2020年4月启动，包括201,121名完成EPICOVID19问卷的成年人的方便样本。II期问卷的重点是鼻咽拭子（NPS）和血清学测试的结果，已邮寄给所有以前接受过NPS测试的受试者。在完成II期问卷的2703名受试者中，694名（25.7%）为NPS阳性。472例免疫球蛋白G （IgG）和421例免疫球蛋白M (M)检测阳性率分别为22.9%（108/472）和11.6%（49/421）。与nps阴性组相比，nps阳性组的发热（421/694,60.7%比391/2009,19.5%，P< 0.001）、味觉和嗅觉丧失（365/694,52.6%比239/2009,11.9%，P< 0.001）和咳嗽（352/694,50.7%比580/2009,28.9%，P< 0.001）发生率较高。在血清学检查中，igg阳性组的发热发生率（65/108,60.2%比43/364,11.8%，P< 0.001）和肌肉/骨骼/关节疼痛发生率（73/108,67.6%比71/364,19.5%，P< 0.001）高于igg阴性组。对自我报告的COVID-19症状项目进行分析，发现了一种单因素解决方案，即EPICOVID19诊断量表。确定了以下最佳得分：呼吸问题1.03分，胸痛1.07分，味觉和嗅觉丧失0.97分，心动过速（即心悸）1.05分。这些是最重要的症状。对于18-84岁的成年人，nps阳性受试者的临界值为2.56（敏感性：76.56%，特异性：68.24%），igg阳性受试者的临界值为2.59（敏感性：80.37%，特异性：80.17%）。对于年龄≥60岁的受试者，截止评分为1.28，基于IgG抗体存在的准确性提高（敏感性：88.00%，特异性：89.58%）。我们开发了一个简短的诊断量表，从广泛的人群中检测出可能与COVID-19相关的症状。我们的结果支持自我报告症状在识别需要立即临床评估的个体方面的潜力。虽然这些结果来自意大利大流行时期，但这种短诊断量表可以作为未来类似大流行的筛查工具进行优化和测试。
Confirmed COVID-19 cases have been registered in more than 200 countries, and as of July 28, 2020, over 16 million cases have been reported to the World Health Organization. This study was conducted during the epidemic peak of COVID-19 in Italy. The early identification of individuals with suspected COVID-19 is critical in immediately quarantining such individuals. Although surveys are widely used for identifying COVID-19 cases, outcomes, and associated risks, no validated epidemiological tool exists for surveying SARS-CoV-2 infection in the general population. We evaluated the capability of self-reported symptoms in discriminating COVID-19 to identify individuals who need to undergo instrumental measurements. We defined and validated a method for identifying a cutoff score. Our study is phase II of the EPICOVID19 Italian national survey, which launched in April 2020 and included a convenience sample of 201,121 adults who completed the EPICOVID19 questionnaire. The Phase II questionnaire, which focused on the results of nasopharyngeal swab (NPS) and serological tests, was mailed to all subjects who previously underwent NPS tests. Of 2703 subjects who completed the Phase II questionnaire, 694 (25.7%) were NPS positive. Of the 472 subjects who underwent the immunoglobulin G (IgG) test and 421 who underwent the immunoglobulin M test, 22.9% (108/472) and 11.6% (49/421) tested positive, respectively. Compared to NPS-negative subjects, NPS-positive subjects had a higher incidence of fever (421/694, 60.7% vs 391/2009, 19.5%; P<.001), loss of taste and smell (365/694, 52.6% vs 239/2009, 11.9%; P<.001), and cough (352/694, 50.7% vs 580/2009, 28.9%; P<.001). With regard to subjects who underwent serological tests, IgG-positive subjects had a higher incidence of fever (65/108, 60.2% vs 43/364, 11.8%; P<.001) and pain in muscles/bones/joints (73/108, 67.6% vs 71/364, 19.5%; P<.001) than IgG-negative subjects. An analysis of self-reported COVID-19 symptom items revealed a 1-factor solution, the EPICOVID19 diagnostic scale. The following optimal scores were identified: 1.03 for respiratory problems, 1.07 for chest pain, 0.97 for loss of taste and smell 0.97, and 1.05 for tachycardia (ie, heart palpitations). These were the most important symptoms. For adults aged 18-84 years, the cutoff score was 2.56 (sensitivity: 76.56%; specificity: 68.24%) for NPS-positive subjects and 2.59 (sensitivity: 80.37%; specificity: 80.17%) for IgG-positive subjects. For subjects aged ≥60 years, the cutoff score was 1.28, and accuracy based on the presence of IgG antibodies improved (sensitivity: 88.00%; specificity: 89.58%). We developed a short diagnostic scale to detect subjects with symptoms that were potentially associated with COVID-19 from a wide population. Our results support the potential of self-reported symptoms in identifying individuals who require immediate clinical evaluations. Although these results come from the Italian pandemic period, this short diagnostic scale could be optimized and tested as a screening tool for future similar pandemics.
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影响因子：
8.5
作者：
Adorni F;Prinelli F;Bianchi F;Giacomelli A;Pagani G;Bernacchia D;Rusconi S;Maggi S;Trevisan C;Noale M;Molinaro S;Bastiani L;Fortunato L;Jesuthasan N;Sojic A;Pettenati C;Tavio M;Andreoni M;Mastroianni C;Antonelli Incalzi R;Galli M
通讯作者：
Galli M
影响因子：
82.9
作者：
Long, Quan-Xin;Liu, Bai-Zhong;Huang, Ai-Long
通讯作者：
Huang, Ai-Long
影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
168.9
作者：
Chan, Jasper Fuk-Woo;Yuan, Shuofeng;Yuen, Kwok-Yung
通讯作者：
Yuen, Kwok-Yung
DOI：
10.1093/jamia/ocaa037
发表时间：
2020-06-01
影响因子：
6.4
作者：
Reeves, J. Jeffery;Hollandsworth, Hannah M.;Longhurst, Christopher A.
通讯作者：
Longhurst, Christopher A.