Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.

<h4>Background</h4>Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict CO...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Joshua Elliott, Matthew Whitaker, Barbara Bodinier, Oliver Eales, Steven Riley, Helen Ward, Graham Cooke, Ara Darzi, Marc Chadeau-Hyam, Paul Elliott
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/df15cc8947f14ab29bd1ca8b23f07a5c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:df15cc8947f14ab29bd1ca8b23f07a5c
record_format	dspace
spelling	oai:doaj.org-article:df15cc8947f14ab29bd1ca8b23f07a5c2021-12-02T19:56:01ZPredictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.1549-12771549-167610.1371/journal.pmed.1003777https://doaj.org/article/df15cc8947f14ab29bd1ca8b23f07a5c2021-09-01T00:00:00Zhttps://doi.org/10.1371/journal.pmed.1003777https://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and investigated whether predictive symptoms differ between the B.1.1.7 (Alpha) lineage (predominating as of April 2021 in the US, UK, and elsewhere) and wild type.<h4>Methods and findings</h4>We obtained throat and nose swabs with valid SARS-CoV-2 PCR test results from 1,147,370 volunteers aged 5 years and above (6,450 positive cases) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This study involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%-27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR-positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least 1 symptom identified 7 symptoms as jointly and positively predictive of PCR positivity in rounds 2-7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The resulting model (rounds 2-7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same 7 symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although when comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. The main limitations of our study are (i) potential participation bias despite random sampling of named individuals from the National Health Service register and weighting designed to achieve a representative sample of the population of England and (ii) the necessary reliance on self-reported symptoms, which may be prone to recall bias and may therefore lead to biased estimates of symptom prevalence in England.<h4>Conclusions</h4>Where testing capacity is limited, it is important to use tests in the most efficient way possible. We identified a set of 7 symptoms that, when considered together, maximize detection of COVID-19 in the community, including infection with the B.1.1.7 lineage.Joshua ElliottMatthew WhitakerBarbara BodinierOliver EalesSteven RileyHelen WardGraham CookeAra DarziMarc Chadeau-HyamPaul ElliottPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 18, Iss 9, p e1003777 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Joshua Elliott Matthew Whitaker Barbara Bodinier Oliver Eales Steven Riley Helen Ward Graham Cooke Ara Darzi Marc Chadeau-Hyam Paul Elliott Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.
description	<h4>Background</h4>Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and investigated whether predictive symptoms differ between the B.1.1.7 (Alpha) lineage (predominating as of April 2021 in the US, UK, and elsewhere) and wild type.<h4>Methods and findings</h4>We obtained throat and nose swabs with valid SARS-CoV-2 PCR test results from 1,147,370 volunteers aged 5 years and above (6,450 positive cases) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This study involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%-27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR-positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least 1 symptom identified 7 symptoms as jointly and positively predictive of PCR positivity in rounds 2-7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The resulting model (rounds 2-7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same 7 symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although when comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. The main limitations of our study are (i) potential participation bias despite random sampling of named individuals from the National Health Service register and weighting designed to achieve a representative sample of the population of England and (ii) the necessary reliance on self-reported symptoms, which may be prone to recall bias and may therefore lead to biased estimates of symptom prevalence in England.<h4>Conclusions</h4>Where testing capacity is limited, it is important to use tests in the most efficient way possible. We identified a set of 7 symptoms that, when considered together, maximize detection of COVID-19 in the community, including infection with the B.1.1.7 lineage.
format	article
author	Joshua Elliott Matthew Whitaker Barbara Bodinier Oliver Eales Steven Riley Helen Ward Graham Cooke Ara Darzi Marc Chadeau-Hyam Paul Elliott
author_facet	Joshua Elliott Matthew Whitaker Barbara Bodinier Oliver Eales Steven Riley Helen Ward Graham Cooke Ara Darzi Marc Chadeau-Hyam Paul Elliott
author_sort	Joshua Elliott
title	Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.
title_short	Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.
title_full	Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.
title_fullStr	Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.
title_full_unstemmed	Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.
title_sort	predictive symptoms for covid-19 in the community: react-1 study of over 1 million people.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/df15cc8947f14ab29bd1ca8b23f07a5c
work_keys_str_mv	AT joshuaelliott predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT matthewwhitaker predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT barbarabodinier predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT olivereales predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT stevenriley predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT helenward predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT grahamcooke predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT aradarzi predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT marcchadeauhyam predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople AT paulelliott predictivesymptomsforcovid19inthecommunityreact1studyofover1millionpeople
_version_	1718375872557219840

Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.

Ejemplares similares