@article{Bird_O-2024_168613,
title = {The predictive role of symptoms in COVID-19 diagnostic models: A longitudinal insight},
author = {Bird, O. and Galiza, E. and Baxter, D. and Boffito, M. and Browne, D. and Burns, F. and Chadwick, D. and Clark, R. and Cosgrove, C. and Galloway, J. and Goodman, A. and Heer, A. and Higham, A. and Iyengar, S. and Jeanes, C. and Kalra, P. and Kyriakidou, C. and Bradley, J. and Munthali, C. and Minassian, A. and McGill, F. and Moore, P. and Munsoor, I. and Nicholls, H. and Osanlou, O. and Packham, J. and Pretswell, C. and San Francisco Ramos, A. and Saralaya, D. and Sheridan, R. and Smith, R. and Soiza, R. and Swift, P. and Thomson, E. and Turner, J. and Viljoen, M. and Heath, P. and Ster, I.},
month = {jan},
year = {2024},
abstract = {To investigate the symptoms of SARS-CoV-2 infection, their dynamics and their discriminatory power for the disease using longitudinally, prospectively collected information reported at the time of their occurrence. We have analysed data from a large phase 3 clinical UK COVID-19 vaccine trial. The alpha variant was the predominant strain. Participants were assessed for SARS-CoV-2 infection via nasal/throat PCR at recruitment, vaccination appointments, and when symptomatic. Statistical techniques were implemented to infer estimates representative of the UK population, accounting for multiple symptomatic episodes associated with one individual. An optimal diagnostic model for SARS-CoV-2 infection was derived. The 4-month prevalence of SARS-CoV-2 was 2.1%; increasing to 19.4% (16.0%–22.7%) in participants reporting loss of appetite and 31.9% (27.1%–36.8%) in those with anosmia/ageusia. The model identified anosmia and/or ageusia, fever, congestion, and cough to be significantly associated with SARS-CoV-2 infection. Symptoms’ dynamics were vastly different in the two groups; after a slow start peaking later and lasting longer in PCR+ participants, whilst exhibiting a consistent decline in PCR- participants, with, on average, fewer than 3 days of symptoms reported. Anosmia/ageusia peaked late in confirmed SARS-CoV-2 infection (day 12), indicating a low discrimination power for early disease diagnosis.},
volume = {152},
journal = {Epidemiology and Infection},
publisher = {Cambridge University Press},
url = {https://doi.org/10.1017/S0950268824000037},
}
