Evidence map›Paper›PMID 34898635›Full record

ArticlePloS one2021

Diagnostic value of symptoms for pediatric SARS-CoV-2 infection in a primary care setting.

Chien-Hsiang Weng, Wesley Wing Wah Butt, Meredith B Brooks, Claudia Clarke, Helen E Jenkins, Sabina D Holland, Silvia S Chiang

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 32% 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

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
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

7 authors at 4 institutions in 1 country.

Chien-Hsiang WengDepartment of Family Medicine, Brown University Warren Alpert Medical School, Providence, RI, United States of America.ORCID 0000-0002-0794-1263
Wesley Wing Wah ButtDepartment of Family Medicine, Brown University Warren Alpert Medical School, Providence, RI, United States of America.
Meredith B BrooksDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America.ORCID 0000-0003-1022-2515
Claudia ClarkeProvidence Community Health Centers, Providence, RI, United States of America.
Helen E JenkinsDepartment of Biostatistics, Boston University School of Public Health, Boston, MA, United States of America.
Sabina D HollandDepartment of Pediatrics, Brown University Warren Alpert Medical School, Providence, RI, United States of America.
Silvia S ChiangDepartment of Pediatrics, Brown University Warren Alpert Medical School, Providence, RI, United States of America.ORCID 0000-0002-2318-3802
Providence College · USBrown University · USBoston University · USHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the diagnostic value of symptoms used by daycares and schools to screen children and adolescents for SARS-CoV-2 infection, we analyzed data from a primary care setting.

methodsThis cohort study included all patients ≤17 years old who were evaluated at Providence Community Health Centers (PCHC; Providence, U.S.), for COVID-19 symptoms and/or exposure, and received SARS-CoV-2 polymerase chain reaction (PCR) testing between March-June 2020. Participants were identified from PCHC electronic medical records. For three age groups- 0-4, 5-11, and 12-17 years-we estimated the sensitivity, specificity, and area under the receiver operating curve (AUC) of individual symptoms and three symptom combinations: a case definition published by the Rhode Island Department of Health (RIDOH), and two novel combinations generated by different statistical approaches to maximize sensitivity, specificity, and AUC. We evaluated symptom combinations both with and without consideration of COVID-19 exposure. Myalgia, headache, sore throat, abdominal pain, nausea, anosmia, and ageusia were not assessed in 0-4 year-olds due to the lower reliability of these symptoms in this group.

resultsOf 555 participants, 217 (39.1%) were SARS-CoV-2-infected. Fever was more common among 0-4 years-olds (p = 0.002); older children more frequently reported fatigue (p = 0.02). In children ≥5 years old, anosmia or ageusia had 94-98% specificity. In all ages, exposure history most accurately predicted infection. With respect to individual symptoms, cough most accurately predicted infection in <5 year-olds (AUC 0.69) and 12-17 year-olds (AUC 0.62), while headache was most accurate in 5-11 year-olds (AUC 0.62). In combination with exposure history, the novel symptom combinations generated statistically to maximize test characteristics had sensitivity >95% but specificity <30%. No symptom or symptom combination had AUC ≥0.70.

conclusionsAnosmia or ageusia in children ≥5 years old should raise providers' index of suspicion for COVID-19. However, our overall findings underscore the limited diagnostic value of symptoms.

Indexed as

AdolescentAge DistributionAgeusiaArea Under CurveChildChild, PreschoolCohort StudiesCommunity Health CentersCoughCOVID-19Diagnostic Tests, RoutineElectronic Health RecordsHeadacheHumansInfantInfant, Newborn

Identifiers

PMID34898635
PMCPMC8668089
OpenAlexW4226264487

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.