tetano
Editor, Senior Moderator
BMJ
. 2020 Dec 2;371:m4529.
doi: 10.1136/bmj.m4529.
Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study
Elias Eythorsson[SUP] 1 [/SUP], Dadi Helgason[SUP] 1 [/SUP], Ragnar Freyr Ingvarsson[SUP] 1 [/SUP], Helgi K Bjornsson[SUP] 1 [/SUP], Lovisa Bjork Olafsdottir[SUP] 1 [/SUP], Valgerdur Bjarnadottir[SUP] 1 [/SUP], Hrafnhildur Linnet Runolfsdottir[SUP] 1 [/SUP], Solveig Bjarnadottir[SUP] 1 2 [/SUP], Arnar Snaer Agustsson[SUP] 1 [/SUP], Kristin Oskarsdottir[SUP] 1 [/SUP], Hrafn Hliddal Thorvaldsson[SUP] 1 [/SUP], Gudrun Kristjansdottir[SUP] 1 2 [/SUP], Brynja Armannsdottir[SUP] 1 [/SUP], Agnar Bjarnason[SUP] 1 2 [/SUP], Birgir Johannsson[SUP] 1 [/SUP], Olafur Gudlaugsson[SUP] 1 [/SUP], Magnus Gottfredsson[SUP] 1 2 [/SUP], Martin I Sigurdsson[SUP] 1 2 [/SUP], Olafur S Indridason[SUP] 1 [/SUP], Runolfur Palsson[SUP] 3 2 [/SUP]
Affiliations
Abstract
Objective: To characterise the symptoms of coronavirus disease 2019 (covid-19).
Design: Population based cohort study.
Setting: Iceland.
Participants: All individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) between 17 March and 30 April 2020. Cases were identified by three testing strategies: targeted testing guided by clinical suspicion, open invitation population screening based on self referral, and random population screening. All identified cases were enrolled in a telehealth monitoring service, and symptoms were systematically monitored from diagnosis to recovery.
Main outcome measures: Occurrence of one or more of 19 predefined symptoms during follow-up.
Results: Among 1564 people positive for SARS-CoV-2, the most common presenting symptoms were myalgia (55%), headache (51%), and non-productive cough (49%). At the time of diagnosis, 83 (5.3%) individuals reported no symptoms, of whom 49 (59%) remained asymptomatic during follow-up. At diagnosis, 216 (14%) and 349 (22%) people did not meet the case definition of the Centers for Disease Control and Prevention and the World Health Organization, respectively. Most (67%) of the SARS-CoV-2-positive patients had mild symptoms throughout the course of their disease.
Conclusion: In the setting of broad access to RT-PCR testing, most SARS-CoV-2-positive people were found to have mild symptoms. Fever and dyspnoea were less common than previously reported. A substantial proportion of SARS-CoV-2-positive people did not meet recommended case definitions at the time of diagnosis.
. 2020 Dec 2;371:m4529.
doi: 10.1136/bmj.m4529.
Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study
Elias Eythorsson[SUP] 1 [/SUP], Dadi Helgason[SUP] 1 [/SUP], Ragnar Freyr Ingvarsson[SUP] 1 [/SUP], Helgi K Bjornsson[SUP] 1 [/SUP], Lovisa Bjork Olafsdottir[SUP] 1 [/SUP], Valgerdur Bjarnadottir[SUP] 1 [/SUP], Hrafnhildur Linnet Runolfsdottir[SUP] 1 [/SUP], Solveig Bjarnadottir[SUP] 1 2 [/SUP], Arnar Snaer Agustsson[SUP] 1 [/SUP], Kristin Oskarsdottir[SUP] 1 [/SUP], Hrafn Hliddal Thorvaldsson[SUP] 1 [/SUP], Gudrun Kristjansdottir[SUP] 1 2 [/SUP], Brynja Armannsdottir[SUP] 1 [/SUP], Agnar Bjarnason[SUP] 1 2 [/SUP], Birgir Johannsson[SUP] 1 [/SUP], Olafur Gudlaugsson[SUP] 1 [/SUP], Magnus Gottfredsson[SUP] 1 2 [/SUP], Martin I Sigurdsson[SUP] 1 2 [/SUP], Olafur S Indridason[SUP] 1 [/SUP], Runolfur Palsson[SUP] 3 2 [/SUP]
Affiliations
- PMID: 33268329
- DOI: 10.1136/bmj.m4529
Abstract
Objective: To characterise the symptoms of coronavirus disease 2019 (covid-19).
Design: Population based cohort study.
Setting: Iceland.
Participants: All individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) between 17 March and 30 April 2020. Cases were identified by three testing strategies: targeted testing guided by clinical suspicion, open invitation population screening based on self referral, and random population screening. All identified cases were enrolled in a telehealth monitoring service, and symptoms were systematically monitored from diagnosis to recovery.
Main outcome measures: Occurrence of one or more of 19 predefined symptoms during follow-up.
Results: Among 1564 people positive for SARS-CoV-2, the most common presenting symptoms were myalgia (55%), headache (51%), and non-productive cough (49%). At the time of diagnosis, 83 (5.3%) individuals reported no symptoms, of whom 49 (59%) remained asymptomatic during follow-up. At diagnosis, 216 (14%) and 349 (22%) people did not meet the case definition of the Centers for Disease Control and Prevention and the World Health Organization, respectively. Most (67%) of the SARS-CoV-2-positive patients had mild symptoms throughout the course of their disease.
Conclusion: In the setting of broad access to RT-PCR testing, most SARS-CoV-2-positive people were found to have mild symptoms. Fever and dyspnoea were less common than previously reported. A substantial proportion of SARS-CoV-2-positive people did not meet recommended case definitions at the time of diagnosis.