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Abstract

Background

Universal SARS-CoV-2 testing at hospital admission has been proposed to prevent nosocomial transmission.

Aim

To investigate SARS-CoV-2 positivity in patients tested with low clinical COVID-19 suspicion at hospital admission.

Methods

We characterised a retrospective cohort of patients admitted to Karolinska University Hospital tested for SARS-CoV-2 by PCR from March to September 2020, supplemented with an in-depth chart review (16 March–12 April). We compared positivity rates in patients with and without clinical COVID-19 suspicion with Spearman’s rank correlation coefficient. We used multivariable logistic regression to identify factors associated with test positivity.

Results

From March to September 2020, 66.9% (24,245/36,249) admitted patient episodes were tested; of those, 61.2% (14,830/24,245) showed no clinical COVID-19 suspicion, and the positivity rate was 3.2% (469/14,830). There was a strong correlation of SARS-CoV-2 positivity in patients with low vs high COVID-19 suspicion (rho = 0.92; p < 0.001).

From 16 March to 12 April, the positivity rate was 3.9% (58/1,482) in individuals with low COVID-19 suspicion, and 3.1% (35/1,114) in asymptomatic patients. Rates were higher in women (5.0%; 45/893) vs men (2.0%; 12/589; p = 0.003), but not significantly different if pregnant women were excluded (3.7% (21/566) vs 2.2% (12/589); p = 0.09). Factors associated with SARS-CoV-2 positivity were testing of pregnant women before delivery (odds ratio (OR): 2.6; 95% confidence interval (CI): 1.3–5.4) and isolated symptoms in adults (OR: 3.3; 95% CI: 1.8–6.3).

Conclusions

This study shows a relatively high SARS-CoV-2 positivity rate in patients with low COVID-19 suspicion upon hospital admission. Universal SARS-CoV-2 testing of pregnant women before delivery should be considered.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2022-02-17
2024-12-22
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References

  1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533-4.  https://doi.org/10.1016/S1473-3099(20)30120-1  PMID: 32087114 
  2. World Health Organization (WHO). COVID–19 Strategy Update. Geneva: WHO; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/covid-strategy-update-14april2020.pdf
  3. Cheemarla NR, Brito AF, Fauver JR, Alpert T, Vogels CBF, Omer SB, et al. Host response-based screening to identify undiagnosed cases of COVID-19 and expand testing capacity. medRxiv2020.06.04.20109306. Preprint.  https://doi.org/10.1101/2020.06.04.20109306 
  4. Benítez MA, Velasco C, Sequeira AR, Henríquez J, Menezes FM, Paolucci F. Responses to COVID-19 in five Latin American countries. Health Policy Technol. 2020;9(4):525-59.  https://doi.org/10.1016/j.hlpt.2020.08.014  PMID: 32874863 
  5. Rivett L, Sridhar S, Sparkes D, Routledge M, Jones NK, Forrest S, et al. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. eLife. 2020;9:e58728.  https://doi.org/10.7554/eLife.58728  PMID: 32392129 
  6. Ra SH, Lim JS, Kim GU, Kim MJ, Jung J, Kim S-H. Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection. Thorax. 2021;76(1):61-3.  https://doi.org/10.1136/thoraxjnl-2020-215042  PMID: 32963115 
  7. Ravindra K, Malik VS, Padhi BK, Goel S, Gupta M. Asymptomatic infection and transmission of COVID-19 among clusters: systematic review and meta-analysis. Public Health. 2022;203:100-9.  https://doi.org/10.1016/j.puhe.2021.12.003  PMID: 35038628 
  8. Porcel-Vazquez JA, Andres-Peiro JV, Garcia-Sanchez Y, Guerra-Farfan E, Mestre-Torres J, Minguell-Monyart J, et al. Usefulness of PCR screening in the initial triage of trauma patients during COVID-19 pandemic. J Orthop Trauma. 2020;34(10):e377-81.  https://doi.org/10.1097/BOT.0000000000001903  PMID: 32947588 
  9. Goldfarb IT, Diouf K, Barth WH Jr, Robinson JN, Katz D, Gregory KE, et al. Universal SARS-CoV-2 testing on admission to the labor and delivery unit: Low prevalence among asymptomatic obstetric patients. Infect Control Hosp Epidemiol. 2020;41(9):1095-6.  https://doi.org/10.1017/ice.2020.255  PMID: 32456729 
  10. Black JRM, Bailey C, Przewrocka J, Dijkstra KK, Swanton C. COVID-19: the case for health-care worker screening to prevent hospital transmission. Lancet. 2020;395(10234):1418-20.  https://doi.org/10.1016/S0140-6736(20)30917-X  PMID: 32305073 
  11. Story D, Coyle E, Devapalasundaram A, Sidiropoulos S, Ou Yang B, Coulson T. Documenting COVID-19 screening before surgery during lockdown (COVID Screen): an audit with routinely collected health data. Aust Health Rev. 2020;44(5):723-7.  https://doi.org/10.1071/AH20169  PMID: 32962798 
  12. European Centre for Disease Prevention and Control (ECDC). COVID-19 testing strategies and objectives. Stockholm: ECDC. [Accessed: 28 Jan 2022]. Available from: https://www.ecdc.europa.eu/en/publications-data/covid-19-testing-strategies-and-objectives
  13. Marshall S, Ishikawa M, Tanaka H, Sakura H, Uchigata Y. Universal testing for SARS-CoV-2 infection on admission among hospitalized emergency patients: A survey report from a single facility in Tokyo. Infect Dis Health. 2022;27(1):58-60.  https://doi.org/10.1016/j.idh.2021.09.002  PMID: 34627745 
  14. World Health Organization (WHO). WHO Coronavirus Disease (COVID-19) Dashboard. Geneva: WHO. [Accessed: 15 Nov 2020]. Available from: https://covid19.who.int/region/euro/country/se
  15. Folkhälsomyndigheten (FOHM). Antal fall av Covid-19 i Sverige på regionnivå. [Number of cases of COVID-19 in Sweden at the regional level]. Stockholm: FOHM. [Accessed: 16 Nov 2020]. Swedish. Available from: https://fohm.maps.arcgis.com/apps/opsdashboard/index.html#/21a20798598b4badb417ff63dbc963dc
  16. Statistiska centralbyrån (SCB). Förmögenhetsstatistik för personer efter region, kön, ålder, tillgångar/skulder. År 2004 – 2007. [Wealth statistics for persons by region, sex, age, assets / liabilities. Year 2004 – 2007]. Stockholm: SCB. [Accessed: 6 Dec 2020]. Swedish. Available from: http://www.statistikdatabasen.scb.se/pxweb/sv/ssd/START__HE__HE0104/TillgOversiktAldReg
  17. Aslam A, Singh J, Robilotti E, Chow K, Bist T, Reidy-Lagunes D, et al. Severe acute respiratory syndrome coronavirus 2 surveillance and exposure in the perioperative setting with universal testing and personal protective equipment policies. Clin Infect Dis. 2021;73(9):e3013-8.  https://doi.org/10.1093/cid/ciaa1607  PMID: 33090210 
  18. Shah MA, Mayer S, Emlen F, Sholle E, Christos P, Cushing M, et al. Clinical screening for COVID-19 in asymptomatic patients with cancer. JAMA Netw Open. 2020;3(9):e2023121.  https://doi.org/10.1001/jamanetworkopen.2020.23121  PMID: 32990737 
  19. Sastry SR, Pryor R, Raybould JE, Reznicek J, Cooper K, Patrick A, et al. Universal screening for the SARS-CoV-2 virus on hospital admission in an area with low COVID-19 prevalence. Infect Control Hosp Epidemiol. 2020;41(10):1231-3.  https://doi.org/10.1017/ice.2020.358  PMID: 32698924 
  20. Sutton D, Fuchs K, D’Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med. 2020;382(22):2163-4.  https://doi.org/10.1056/NEJMc2009316  PMID: 32283004 
  21. Yassa M, Yirmibes C, Cavusoglu G, Eksi H, Dogu C, Usta C, et al. Outcomes of universal SARS-CoV-2 testing program in pregnant women admitted to hospital and the adjuvant role of lung ultrasound in screening: a prospective cohort study. J Matern Fetal Neonatal Med. 2020;33(22):3820-6.  https://doi.org/10.1080/14767058.2020.1798398  PMID: 32691641 
  22. Tanacan A, Erol SA, Turgay B, Anuk AT, Secen EI, Yegin GF, et al. The rate of SARS-CoV-2 positivity in asymptomatic pregnant women admitted to hospital for delivery: Experience of a pandemic center in Turkey. Eur J Obstet Gynecol Reprod Biol. 2020;253:31-4.  https://doi.org/10.1016/j.ejogrb.2020.07.051  PMID: 32763728 
  23. Leavitt AO, Li Q, Chan ED. Re: Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study: Common pathophysiology of pre-eclampsia and severe COVID-19? BJOG. 2021;128(3):618-9.  https://doi.org/10.1111/1471-0528.16584  PMID: 33225566 
  24. Ontario Ministry of Health. COVID-19 Provincial Testing Guidance Update. Ontario: Ministry of Health. [Accessed: 29 Jan 2022]. Available from: https://www.rhra.ca/wp-content/uploads/2021/05/2021_testing_guidance.pdf
  25. Díaz-Corvillón P, Mönckeberg M, Barros A, Illanes SE, Soldati A, Nien JK, et al. Routine screening for SARS CoV-2 in unselected pregnant women at delivery. PLoS One. 2020;15(9):e0239887.  https://doi.org/10.1371/journal.pone.0239887  PMID: 32991621 
  26. Nakamura I, Itoi T. Universal PCR screening for coronavirus disease 2019 in asymptomatic patients on admission. Clin Microbiol Infect. 2021;27(4):658-9.  https://doi.org/10.1016/j.cmi.2020.11.010  PMID: 33221431 
  27. Lundkvist Å, Hanson S, Olsen B. Pronounced difference in Covid-19 antibody prevalence indicates cluster transmission in Stockholm, Sweden. Infect Ecol Epidemiol. 2020;10(1):1806505.  https://doi.org/10.1080/20008686.2020.1806505  PMID: 32944166 
  28. Kahlberg A, Mascia D, Bellosta R, Attisani L, Pegorer M, Socrate AM, et al. Vascular surgery during COVID-19 emergency in hub hospitals of Lombardy: Experience on 305 patients. Eur J Vasc Endovasc Surg. 2021;61(2):306-15.  https://doi.org/10.1016/j.ejvs.2020.10.025  PMID: 33262093 
  29. National Health Service (NHS). Healthcare associated COVID-19 infections – further action. London: NHS; 2020. Available from: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/Healthcare-associated-COVID-19-infections--further-action-24-June-2020.pdf
  30. Poline J, Gaschignard J, Leblanc C, Madhi F, Foucaud E, Nattes E, et al. Systematic Severe acute respiratory syndrome coronavirus 2 screening at hospital admission in children: a French prospective multicenter study. Clin Infect Dis. 2021;72(12):2215-7.  https://doi.org/10.1093/cid/ciaa1044  PMID: 32710743 
SARS-CoV-2 testing in patients with low COVID-19 suspicion at admission to a tertiary care hospital, Stockholm, Sweden, March to September 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Ana+Requena-M%C3%A9ndez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Requena-Méndez Ana</a>, <a href="/search?value1=Aikaterini+Mougkou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mougkou Aikaterini</a>, <a href="/search?value1=Pontus+Hedberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hedberg Pontus</a>, <a href="/search?value1=Suzanne+D+van+der+Werff&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van der Werff Suzanne D</a>, <a href="/search?value1=Hideyuki+Tanushi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tanushi Hideyuki</a>, <a href="/search?value1=Olof+Hertting&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hertting Olof</a>, <a href="/search?value1=Anna+F%C3%A4rnert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Färnert Anna</a>, <a href="/search?value1=Filippa+Nyberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nyberg Filippa</a>, <a href="/search?value1=Pontus+Naucler&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Naucler Pontus</a>, <a href="/search?value1=COVID-19-data-review+collaborators&option1=author&noRedirect=true" class="nonDisambigAuthorLink">COVID-19-data-review collaborators</a></span>. SARS-CoV-2 testing in patients with low COVID-19 suspicion at admission to a tertiary care hospital, Stockholm, Sweden, March to September 2020. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(7):pii=2100079. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.7.2100079" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.7.2100079</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 19 Jan 2021;&nbsp;&nbsp; <span class="generated">Accepted</span>: 05 May 2021 </span> </p>
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