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. 2022 Aug 24;75(1):e1180-e1183.
doi: 10.1093/cid/ciac129.

Self-Assessed Severity as a Determinant of Coronavirus Disease 2019 Symptom Specificity: A Longitudinal Cohort Study

Anna Bershteyn  1 , Angela M Dahl  2 , Tracy Q Dong  3 , Meagan E Deming  4 , Connie L Celum  5 , Helen Y Chu  6 , Angelica C Kottkamp  7 , Alexander L Greninger  3   8 , Risa M Hoffman  9 , Keith R Jerome  3   8 , Christine M Johnston  10 , Patricia J Kissinger  11 , Raphael J Landovitz  12 , Miriam K Laufer  4 , Alfred Luk  13 , Kathleen M Neuzil  4 , Michael K Paasche-Orlow  14 , Robert A Pitts  15 , Mark D Schwartz  1 , Helen C Stankiewicz Karita  16 , Lorna E Thorpe  1 , Anna Wald  3   8   17 , Crystal Y Zheng  13 , Mark H Wener  8 , Ruanne V Barnabas  18   19 , Elizabeth R Brown  2   20
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Self-Assessed Severity as a Determinant of Coronavirus Disease 2019 Symptom Specificity: A Longitudinal Cohort Study

Anna Bershteyn et al. Clin Infect Dis. .

Abstract

Coronavirus disease 2019 symptom definitions rarely include symptom severity. We collected daily nasal swab samples and symptom diaries from contacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) case patients. Requiring ≥1 moderate or severe symptom reduced sensitivity to predict SARS-CoV-2 shedding from 60.0% (95% confidence interval [CI], 52.9%-66.7%) to 31.5% (95% CI, 25.7%- 38.0%) but increased specificity from 77.5% (95% CI, 75.3%-79.5%) to 93.8% (95% CI, 92.7%-94.8%).

Keywords: COVID-19; SARS-CoV-2; screening; severity; symptoms.

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Figures

Figure 1.
Figure 1.
Number of person-days during which participants did not meet Centers for Disease Control and Prevention (CDC) symptom criteria (gray) or met CDC symptom criteria with only mild symptoms (blue), ≥1 moderate symptom (purple), or ≥1 severe symptom (red). Person-days are shown according to whether a participant is concurrently shedding (A), not concurrently shedding (B), or never shedding during follow-up (D) and by day since shedding onset (C). Lines between bars in (C) depict changes in symptom status of individual participants on sequential days.
See this image and copyright information in PMC

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