tetano
Editor, Senior Moderator
BMC Pediatr
. 2022 Nov 10;22(1):655.
doi: 10.1186/s12887-022-03729-w.
Utility of illness symptoms for predicting COVID-19 infections in children
Geena Y Zhou[SUP] 1 [/SUP], Nicole Y Penwill[SUP] 2 [/SUP], Grace Cheng[SUP] 3 [/SUP], Prachi Singh[SUP] 4 [/SUP], Ann Cheung[SUP] 5 [/SUP], Minkyung Shin[SUP] 4 [/SUP], Margaret Nguyen[SUP] 4 [/SUP], Shalini Mittal[SUP] 4 [/SUP], William Burrough[SUP] 4 [/SUP], Mia-Ashley Spad[SUP] 4 [/SUP], Sarah Bourne[SUP] 4 [/SUP], Naomi S Bardach[SUP] #[/SUP][SUP] 4 [/SUP], Emily R Perito[SUP] #[/SUP][SUP] 6 [/SUP]
Affiliations
Abstract
Background: The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that symptomatic children remain home and get tested to identify potential coronavirus disease 2019 (COVID-19) cases. As the pandemic moves into a new phase, approaches to differentiate symptoms of COVID-19 versus other childhood infections can inform exclusion policies and potentially prevent future unnecessary missed school days.
Methods: Retrospective analysis of standardized symptom and exposure screens in symptomatic children 0-18 years tested for SARS-CoV-2 at three outpatient sites April to November 2020. Likelihood ratios (LR), number needed to screen to identify one COVID-19 case, and estimated missed school days were calculated.
Results: Of children studied (N = 2,167), 88.9% tested negative. Self-reported exposure to COVID-19 was the only factor that statistically significantly increased the likelihood of a positive test for all ages (Positive LR, 5-18 year olds: 5.26, 95% confidence interval (CI): 4.37-6.33; 0-4 year olds: 5.87, 95% CI: 4.67-7.38). Across ages 0-18, nasal congestion/rhinorrhea, sore throat, abdominal pain, and nausea/vomiting/diarrhea were commonly reported, and were either not associated or had decreased association with testing positive for COVID-19. The number of school days missed to identify one case of COVID-19 ranged from 19 to 48 across those common symptoms.
Conclusions: We present an approach for identifying symptoms that are non-specific to COVID-19, for which exclusion would likely lead to limited impact on school safety but contribute to school-days missed. As variants and symptoms evolve, students and schools could benefit from reconsideration of exclusion and testing policies for non-specific symptoms, while maintaining testing for those who were exposed.
Keywords: COVID-19; School; Screening; Symptoms; Testing; Testing and exclusion.
. 2022 Nov 10;22(1):655.
doi: 10.1186/s12887-022-03729-w.
Utility of illness symptoms for predicting COVID-19 infections in children
Geena Y Zhou[SUP] 1 [/SUP], Nicole Y Penwill[SUP] 2 [/SUP], Grace Cheng[SUP] 3 [/SUP], Prachi Singh[SUP] 4 [/SUP], Ann Cheung[SUP] 5 [/SUP], Minkyung Shin[SUP] 4 [/SUP], Margaret Nguyen[SUP] 4 [/SUP], Shalini Mittal[SUP] 4 [/SUP], William Burrough[SUP] 4 [/SUP], Mia-Ashley Spad[SUP] 4 [/SUP], Sarah Bourne[SUP] 4 [/SUP], Naomi S Bardach[SUP] #[/SUP][SUP] 4 [/SUP], Emily R Perito[SUP] #[/SUP][SUP] 6 [/SUP]
Affiliations
- PMID: 36357876
- DOI: 10.1186/s12887-022-03729-w
Abstract
Background: The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that symptomatic children remain home and get tested to identify potential coronavirus disease 2019 (COVID-19) cases. As the pandemic moves into a new phase, approaches to differentiate symptoms of COVID-19 versus other childhood infections can inform exclusion policies and potentially prevent future unnecessary missed school days.
Methods: Retrospective analysis of standardized symptom and exposure screens in symptomatic children 0-18 years tested for SARS-CoV-2 at three outpatient sites April to November 2020. Likelihood ratios (LR), number needed to screen to identify one COVID-19 case, and estimated missed school days were calculated.
Results: Of children studied (N = 2,167), 88.9% tested negative. Self-reported exposure to COVID-19 was the only factor that statistically significantly increased the likelihood of a positive test for all ages (Positive LR, 5-18 year olds: 5.26, 95% confidence interval (CI): 4.37-6.33; 0-4 year olds: 5.87, 95% CI: 4.67-7.38). Across ages 0-18, nasal congestion/rhinorrhea, sore throat, abdominal pain, and nausea/vomiting/diarrhea were commonly reported, and were either not associated or had decreased association with testing positive for COVID-19. The number of school days missed to identify one case of COVID-19 ranged from 19 to 48 across those common symptoms.
Conclusions: We present an approach for identifying symptoms that are non-specific to COVID-19, for which exclusion would likely lead to limited impact on school safety but contribute to school-days missed. As variants and symptoms evolve, students and schools could benefit from reconsideration of exclusion and testing policies for non-specific symptoms, while maintaining testing for those who were exposed.
Keywords: COVID-19; School; Screening; Symptoms; Testing; Testing and exclusion.