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MeSH Disease

Human Phenotype

Transmission

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Seroprevalence
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    RT-PCR testing to detect a COVID-19 outbreak in Austria: rapid, accurate and early diagnosis in primary care (The REAP study)

    Authors: Werner Leber; Oliver Lammel; Monika Redlberger-Fritz; Maria Elisabeth Mustafa-Korninger; Karin Stiasny; Reingard Christina Glehr; Eva-Maria Hochstrasser; Christian Hoellinger; Andrea Siebenhofer; Chris Griffiths; Jasmina Panovska-Griffiths

    doi:10.1101/2020.07.13.20152439 Date: 2020-07-15 Source: medRxiv

    Background Delay in COVID-19 detection has led to a major pandemic. We report rapid early detection of SARS-CoV-2 by reverse transcriptase-polymerase chain reaction (RT-PCR), comparing it to the serostatus of convalescent infection MESHD, at an Austrian National Sentinel Surveillance Practice in an isolated ski-resort serving a population of 22,829 people. Methods Retrospective dataset of all 73 patients presenting with mild to moderate flu-like symptoms to a sentinel practice in the ski-resort of Schladming-Dachstein, Austria, between 24 February and 03 April, 2020. We split the outbreak in two halves, by dividing the period from the first to the last case by two, to characterise the following three cohorts of patients with confirmed infection TRANS: people with reactive RT-PCR presenting during the first half (early acute infection MESHD) vs. those presenting in the second half (late acute), and people with non-reactive RT-PCR (late convalescent). For each cohort we report the number of cases detected, the accuracy of RT-PCR and the duration of symptoms. We also report multivariate regression of 15 clinical symptoms as covariates, comparing all people with convalescent infection MESHD to those with acute infection MESHD. Findings All 73 patients had SARS-CoV-2 RT-PCR testing. 22 patients were diagnosed with COVID-19, comprising: 8 patients presenting early acute, and 7 presenting late acute and 7 late convalescent respectively; 44 patients tested SARS-COV-2 negative, and 7 were excluded. RT-PCR sensitivity SERO was high (100%) among acute presenters, but dropped to 50% in the second half of the outbreak; specificity was 100%. The mean duration of symptoms was 2 days (range 1-4) among early acute presenters, and 4.4 days (1-7) among late acute and 8 days (2-12) among late convalescent presenters respectively. Convalescent infection MESHD was only associated with loss of taste MESHD (ORs=6.02;p=0.047). Acute infection MESHD was associated with loss of taste MESHD (OR=571.72;p=0.029), nausea and vomiting HP nausea and vomiting MESHD vomiting MESHD (OR=370.11;p=0.018), breathlessness (OR=134.46;p=0.049), and myalgia HP myalgia MESHD (OR=121.82;p=0.032); but not loss of smell, fever HP fever MESHD or cough HP cough MESHD. Interpretation RT-PCR rapidly and reliably detects early COVID-19 among people presenting with viral illness MESHD and multiple symptoms in primary care, particularly during the early phase of an outbreak. RT-PCR testing in primary care should be prioritised for effective COVID-19 prevention and control.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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