Evidence map›Paper›PMID 37870070›Full record

Observational studyThe European journal of general practice2023

Clinical diagnosis of SARS-CoV-2 infection: An observational study of respiratory tract infection in primary care in the early phase of the pandemic.

Alike W van der Velden, Milensu Shanyinde, Emily Bongard, Femke Böhmer, Slawomir Chlabicz, Annelies Colliers, Ana García-Sangenís, Lile Malania, Jozsef Pauer, Angela Tomacinschii and 7 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The European journal of general practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 19% 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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
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

17 authors at 9 institutions in 9 countries.

Alike W van der VeldenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID 0000-0002-9443-2837
Milensu ShanyindeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Emily BongardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Femke BöhmerInstitute of General Practice, Rostock University Medical Center, Rostock, Germany.
Slawomir ChlabiczDepartment of Family Medicine, Medical University of Bialystok, Bialystok, Poland.
Annelies ColliersDepartment of Family Medicine & Population Health, University of Antwerp, Antwerp, Belgium.
Ana García-SangenísInstitut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
Lile MalaniaNational Center for Disease Control and Public Health, Tbilisi and Arner Science Management LLC, Tbilisi, Georgia.
Jozsef PauerDRC Drug Research Centre, Balatonfüred, Hungary.
Angela TomacinschiiUniversity Clinic of Primary Medical Assistance of State University of Medicine and Pharmacy "N. Testemițanu", Chişinǎu, The Republic of Moldova.
Ly-Mee YuNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Katherine LoensLaboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
Margareta IevenLaboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
Theo J VerheijJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Herman GoossensLaboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
Akke VellingaSchool of Public Health, Physiotherapy and Sports Science, University College Dublin (UCD), Dublin, Ireland.
Christopher C ButlerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
University of Antwerp · BEUniversity of Oxford · GBUniversity Medical Center Utrecht · NLInstitut Universitari d'Investigació en Atenció Primària Jordi Gol · ESMedical University of Białystok · PLNational Center for Disease Control and Public Health · GENicolae Testemițanu State University of Medicine and Pharmacy · MDUniversity College Dublin · IEUniversity of Rostock · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly in the COVID-19 pandemic, GPs had to distinguish SARS-CoV-2 from other aetiologies in patients presenting with respiratory tract infection (RTI) symptoms on clinical grounds and adapt management accordingly.

objectivesTo test the diagnostic accuracy of GPs' clinical diagnosis of a SARS-CoV-2 infection in a period when COVID-19 was a new disease. To describe GPs' management of patients presenting with RTI for whom no confirmed diagnosis was available. To investigate associations between patient and clinical features with a SARS-CoV-2 infection.

methodsIn April 2020-March 2021, 876 patients (9 countries) were recruited when they contacted their GP with symptoms of an RTI of unknown aetiology. A swab was taken at baseline for later analysis. Aetiology (PCR), diagnostic accuracy of GPs' clinical SARS-CoV-2 diagnosis, and patient management were explored. Factors related to SARS-CoV-2 infection were determined by logistic regression modelling.

resultsGPs suspected SARS-CoV-2 in 53% of patients whereas 27% of patients tested positive for SARS-CoV-2. True-positive patients (23%) were more intensively managed for follow-up, antiviral prescribing and advice than true-negatives (42%). False negatives (5%) were under-advised, particularly for social distancing and isolation. Older age (OR: 1.02 (1.01-1.03)), male sex (OR: 1.68 (1.16-2.41)), loss of taste/smell (OR: 5.8 (3.7-9)), fever (OR: 1.9 (1.3-2.8)), muscle aches (OR: 2.1 (1.5-3)), and a known risk factor for COVID-19 (travel, health care worker, contact with proven case; OR: 2.7 (1.8-4)) were predictive of SARS-CoV-2 infection. Absence of loss of taste/smell, fever, muscle aches and a known risk factor for COVID-19 correctly excluded SARS-CoV-2 in 92.3% of patients, whereas presence of 3, or 4 of these variables correctly classified SARS-CoV-2 in 57.7% and 87.1%.

conclusionCorrect clinical diagnosis of SARS-CoV-2 infection, without POC-testing available, appeared to be complicated.

Indexed as

AgeusiaCOVID-19COVID-19 TestingHumansMalePainPandemicsPrimary Health CareSARS-CoV-2COVID-19diagnostic accuracypredictionrespiratory tract infectionSARS-CoV-2

Identifiers

PMID37870070
PMCPMC10990254
OpenAlexW4387865357

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.