Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 3;21(1):251.
doi: 10.1186/s12875-020-01322-7.

Risk factors for a positive SARS-CoV-2 PCR in patients with common cold symptoms in a primary care setting - a retrospective analysis based on a joint documentation standard

Johannes Just  1 , Marie-Therese Puth  2 , Felix Regenold  3 , Klaus Weckbecker  3 , Markus Bleckwenn  4
Affiliations

Risk factors for a positive SARS-CoV-2 PCR in patients with common cold symptoms in a primary care setting - a retrospective analysis based on a joint documentation standard

Johannes Just et al. BMC Fam Pract. .

Abstract

Background: Combating the COVID-19 pandemic is a major challenge for health systems, citizens and policy makers worldwide. Early detection of affected patients within the large and heterogeneous group of patients with common cold symptoms is an important element of this effort, but often hindered by limited testing resources, false-negative test results and the lack of pathognomonic symptoms in COVID-19. Therefore, we aimed to identify anamnestic items with an increased/decreased odds ratio for a positive SARS-CoV-2 PCR (CovPCR) result in a primary care setting.

Methods: We performed a multi-center cross-sectional cohort study on predictive clinical characteristics for a positive CovPCR over a period of 4 weeks in primary care patients in Germany.

Results: In total, 374 patients in 14 primary care centers received CovPCR and were included in this analysis. The median age was 44.0 (IQR: 31.0-59.0) and a fraction of 10.7% (n = 40) tested positive for COVID-19. Patients who reported anosmia had a higher odds ratio (OR: 4.54; 95%-CI: 1.51-13.67) for a positive test result while patients with a sore throat had a lower OR (OR: 0.33; 95%-CI: 0.11-0.97). Furthermore, patients who had a first grade contact with an infected persons and showed symptoms themselves also had an increased OR for positive testing (OR: 5.16; 95% CI: 1.72-15.51). This correlation was also present when they themselves were still asymptomatic (OR: 12.55; 95% CI: 3.97-39.67).

Conclusions: Several anamnestic criteria may be helpful to assess pre-test probability of COVID-19 in patients with common cold symptoms.

Keywords: COVID-19; PCR; Positive-predictive value, point-of-care testing, risk factors.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: JJ, MP, KW and MB declare no conflict of interest. Felix Regenold holds shares < 5% of a regulatory affairs service company (Dr. Regenold GmbH) which is run by a family member.

Figures

Fig. 1
Fig. 1
Number of tests separated by test reason per calendar week
See this image and copyright information in PMC

References

    1. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). [cited 2020 Apr 1]. Available from: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-...).
    1. RKI: Daily situation report on COVID-19. Available from: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsb....
    1. RKI: epidemiological update 15/2020. SARS-CoV-2-testing numbers. [cited 2020 Apr 15]. Available from: https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/Ausgaben/15_20....
    1. Schneider A, Dinant G-J, Szecsenyi J. Stepwise diagnostic workup in general practice as a consequence of the Bayesian reasoning. Z Arztl Fortbild Qualitatssich. 2006;100(2):121–127. - PubMed
    1. RKI: Testing guidelines for doctors. [cited 2020 Apr 1]. Available from: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Massnahmen_....