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ENE-COVID nationwide serosurvey served to characterize asymptomatic infections and to develop a symptom-based risk score to predict COVID-19.

Authors
  • Pérez-Gómez, Beatriz1
  • Pastor-Barriuso, Roberto2
  • Pérez-Olmeda, Mayte3
  • Hernán, Miguel A4
  • Oteo-Iglesias, Jesús5
  • de Larrea, Nerea Fernández6
  • Fernández-García, Aurora7
  • Martín, Mariano8
  • Fernández-Navarro, Pablo9
  • Cruz, Israel10
  • Sanmartín, Jose L11
  • Paniagua, Jose León12
  • Muñoz-Montalvo, Juan F13
  • Blanco, Faustino14
  • Yotti, Raquel15
  • Pollán, Marina16
  • 1 National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 2 National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 3 National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), Ctra de Pozuelo 28, 28222 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 4 Departments of Epidemiology and Biostatistics, Harvard T H Chan School of Public Health, Harvard-MIT Division of Health Sciences and Technology, 677 Huntington Ave, Boston, MA 02115, USA. Electronic address: [email protected]
  • 5 National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), Ctra de Pozuelo 28, 28222 Madrid, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 6 National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 7 Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), Ctra de Pozuelo 28, 28222 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 8 Deputy Directorate of Information Technologies, Ministry of Health, Paseo del Prado 18, 28014 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 9 National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 10 National School of Public Health, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 11 Deputy Directorate of Information Technologies, Ministry of Health, Paseo del Prado 18, 28014 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 12 Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 13 Deputy Directorate of Information Technologies, Ministry of Health, Paseo del Prado 18, 28014 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 14 Deputy Directorate of Information Technologies, Ministry of Health, Paseo del Prado 18, 28014 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 15 Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
  • 16 National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain. Electronic address: [email protected] , (Spain)
Type
Published Article
Journal
Journal of clinical epidemiology
Publication Date
Jun 11, 2021
Identifiers
DOI: 10.1016/j.jclinepi.2021.06.005
PMID: 34126206
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To characterize asymptomatic SARS-CoV-2 infections and develop a symptom-based risk score useful in primary healthcare. 61,092 community-dwelling participants in a nationwide population-based serosurvey completed a questionnaire on COVID-19 symptoms and received an immunoassay for SARS-CoV-2 IgG antibodies between April 27-June 22, 2020. Standardized prevalence ratios for asymptomatic infection were estimated across participant characteristics. We constructed a symptom-based risk score and evaluated its ability to predict SARS-CoV-2 infection. 28.7% of infections were asymptomatic (95% CI 26.1-31.4%). Standardized asymptomatic prevalence ratios were 1.19 (1.02-1.40) for men versus women, 1.82 (1.33-2.50) and 1.45 (0.96-2.18) for individuals <20 and ≥80 years versus those aged 40-59, 1.27 (1.03-1.55) for smokers versus non-smokers, and 1.91 (1.59-2.29) for individuals without versus with case contact. In symptomatic population, a symptom-based score (weights: severe tiredness=1; absence of sore throat=1; fever=2; anosmia/ageusia=5) reached standardized seroprevalence ratio of 8.71 (7.37-10.3), discrimination index of 0.79 (0.77-0.81), and sensitivity and specificity of 71.4% (68.1-74.4%) and 74.2% (73.1-75.2%) for a score ≥3. The presence of anosmia/ageusia, fever with severe tiredness, or fever without sore throat should serve to suspect COVID-19 in areas with active viral circulation. The proportion of asymptomatics in children and adolescents challenges infection control. Copyright © 2021. Published by Elsevier Inc.

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