Evidence map›Paper›PMID 34824057›Full record

ArticleThe European respiratory journal2022

Broadening symptom criteria improves early case identification in SARS-CoV-2 contacts.

Hamish Houston, Seran Hakki, Timesh D Pillay, Kieran Madon, Nieves Derqui-Fernandez, Aleksandra Koycheva, Anika Singanayagam, Joe Fenn, Rhia Kundu, Emily Conibear and 15 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The European respiratory journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. COVID-19-associated serum and cerebrospinal fluid cytokines in post- versus para-infectious SARS-CoV-2-related Guillain-Barré syndrome.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 6 institutions in 1 country.

Hamish HoustonNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.ORCID 0000-0001-5302-7563
Seran HakkiNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Timesh D PillayNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Kieran MadonNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Nieves Derqui-FernandezNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.ORCID 0000-0003-2407-3362
Aleksandra KoychevaNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Anika SinganayagamNational Infection Service, Public Health England, London, UK.
Joe FennNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Rhia KunduNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Emily ConibearNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Robert VarroNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Jessica CutajarNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Valerie QuinnNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Lulu WangNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Janakan S NareanNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Mica R Tolosa-WrightNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Jack BarnettNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.
Onn Min KonNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK.ORCID 0000-0003-2647-4688
Richard TedderMolecular Diagnostics Unit, Imperial College London, London, UK.
Graham TaylorSection of Virology, Dept of Infectious Disease, Imperial College London, London, UK.
Maria ZambonNational Infection Service, Public Health England, London, UK.
Neil FergusonDept of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK.
Jake DunningNational Infection Service, Public Health England, London, UK.
Jonathan J DeeksTest Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Ajit LalvaniNIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK a.lalvani@imperial.ac.uk.
NIHR Imperial Biomedical Research Centre · GBImperial College London · GBPublic Health England · GBImperial College Healthcare NHS Trust · GBUniversity of Birmingham · GBUniversity of Liverpool · GB

Funding

Department of Health NIHR200927Medical Research Council MC_PC_19078Medical Research Council MR/R015600/1Medical Research Council MR/R021643/1
6 · The paper itself

Abstract

backgroundThe success of case isolation and contact tracing for the control of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission depends on the accuracy and speed of case identification. We assessed whether inclusion of additional symptoms alongside three canonical symptoms (CS),

methodsTwo prospective longitudinal London (UK)-based cohorts of community SARS-CoV-2 contacts, recruited within 5 days of exposure, provided independent training and test datasets. Infected and uninfected contacts completed daily symptom diaries from the earliest possible time-points. Diagnostic information gained by adding symptoms to the CS was quantified using likelihood ratios and area under the receiver operating characteristic curve. Improvements in sensitivity and time to detection were compared with penalties in terms of specificity and number needed to test.

resultsOf 529 contacts within two cohorts, 164 (31%) developed PCR-confirmed infection and 365 (69%) remained uninfected. In the training dataset (n=168), 29% of infected contacts did not report the CS. Four symptoms (sore throat, muscle aches, headache and appetite loss) were identified as early-predictors (EP) which added diagnostic value to the CS. The broadened symptom criterion "≥1 of the CS, or ≥2 of the EP" identified PCR-positive contacts in the test dataset on average 2 days earlier after exposure (p=0.07) than "≥1 of the CS", with only modest reduction in specificity (5.7%).

conclusionsBroadening symptom criteria to include individuals with at least two of muscle aches, headache, appetite loss and sore throat identifies more infections and reduces time to detection, providing greater opportunities to prevent SARS-CoV-2 transmission.

Indexed as

COVID-19PharyngitisHeadacheHumansPainProspective StudiesSARS-CoV-2

Identifiers

PMID34824057
PMCPMC8620106
OpenAlexW3217457375

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.