Diagnostic accuracy of symptoms as a diagnostic tool for SAR
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The SARS-CoV-2 pandemic continues to be a priority health problem; According to the World Health Organization data from October 13, 2020, 37,704,153 confirmed COVID-19 cases have been reported, including 1,079,029 deaths, since the outbreak. The identification of potential symptoms has been reported to be a useful tool for clinical decision-making in emergency departments to avoid overload and improve the quality of care. The aim of this study was to evaluate the performances of symptoms as a diagnostic tool for SARS -CoV-2 infection.

An observational, cross-sectional, prospective and analytical study was carried out. Data (demographic variables, medical history, respiratory and non-respiratory symptoms) were collected by emergency physicians. The diagnosis of COVID-19 was made using SARS-CoV-2 RT-PCR. The diagnostic accuracy of these characteristics for COVID-19 was evaluated by calculating the positive and negative likelihood ratios.

Results:
-- A prevalence of 53.72% of SARS-CoV-2 infection was observed.

-- The symptom with the highest sensitivity was cough 71%, and a specificity of 52.68%.

-- The symptomatological scale, constructed from 6 symptoms, obtained a sensitivity of 83.45% and a specificity of 32.86%, taking more than 2 symptoms as a cut-off point.

-- The symptoms with the greatest association with SARS-CoV-2 were: anosmia odds ratio (OR) 3.2, fever OR 2.98, dyspnea OR 2.9 and cough OR 2.73.

Conclusively, the combination of more than 2 symptoms / signs (fever, cough, anosmia, dyspnea and oxygen saturation less than 93%, and headache) results in a highly sensitivity model for a quick and accurate diagnosis of COVID-19, and should be used in the absence of ancillary diagnostic studies. Symptomatology, alone and in combination, may be an appropriate strategy to use in the emergency department to guide the behaviors to respond to the disease.

Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05930-1
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