SARS-CoV-2 testing strategy: A comparison of restricted and extended strategies in a Swiss outpatient cohort from the community and hospital employees.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
21
10
2020
accepted:
29
03
2021
entrez:
22
4
2021
pubmed:
23
4
2021
medline:
5
5
2021
Statut:
epublish
Résumé
Testing is a key measure to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we empirically compared two SARS-CoV-2 testing strategies. We used data from a Swiss single-centre, outpatient cohort study (n = 6,331 test results). A "restricted" strategy was applied to individuals with respiratory symptoms and/or fever and selected risk factors, or an epidemiological link and an "extended" strategy included any clinical symptoms without restriction, irrespective of risk factors and exposure. Data on infection, symptoms, viral load were collected during the first wave (March 11-April 21, 2020) and patients were followed up for clinical complications and hospitalisations until August 31, 2020. Infection, clinical complications, and hospitalisation rates were lower for those in the extended strategy compared with the restricted strategy (17.2% vs. 25.0%, 12.3% vs. 20.8%, and 0.7% vs. 2.3%). In the whole cohort, participants included in the extended strategy had a lower number of symptoms (3.51 vs. 4.57; p < .001) and visits occurred earlier after symptom onset (0-3 days: 59.2% vs. 44.2%; p < .001). Among positive cases, the viral load was higher for the extended strategy (p < .001). These findings highlighted the crucial importance to implement a widespread testing strategy to achieve a better understanding of the infection, to mount an effective control response, by capturing people when their viral load is highest. A widespread test strategy should be available without barriers to help break the chains of transmission.
Sections du résumé
BACKGROUND
Testing is a key measure to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we empirically compared two SARS-CoV-2 testing strategies.
METHODS
We used data from a Swiss single-centre, outpatient cohort study (n = 6,331 test results). A "restricted" strategy was applied to individuals with respiratory symptoms and/or fever and selected risk factors, or an epidemiological link and an "extended" strategy included any clinical symptoms without restriction, irrespective of risk factors and exposure. Data on infection, symptoms, viral load were collected during the first wave (March 11-April 21, 2020) and patients were followed up for clinical complications and hospitalisations until August 31, 2020.
FINDINGS
Infection, clinical complications, and hospitalisation rates were lower for those in the extended strategy compared with the restricted strategy (17.2% vs. 25.0%, 12.3% vs. 20.8%, and 0.7% vs. 2.3%). In the whole cohort, participants included in the extended strategy had a lower number of symptoms (3.51 vs. 4.57; p < .001) and visits occurred earlier after symptom onset (0-3 days: 59.2% vs. 44.2%; p < .001). Among positive cases, the viral load was higher for the extended strategy (p < .001).
CONCLUSIONS
These findings highlighted the crucial importance to implement a widespread testing strategy to achieve a better understanding of the infection, to mount an effective control response, by capturing people when their viral load is highest. A widespread test strategy should be available without barriers to help break the chains of transmission.
Identifiants
pubmed: 33886627
doi: 10.1371/journal.pone.0250021
pii: PONE-D-20-33051
pmc: PMC8061911
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0250021Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
PLoS One. 2014 Apr 03;9(4):e94006
pubmed: 24699726
JAMA. 2020 Jun 23;323(24):2522-2524
pubmed: 32459287
Disaster Med Public Health Prep. 2020 Aug;14(4):e1-e2
pubmed: 32295661
Int J Infect Dis. 2020 Jul;96:233-239
pubmed: 32360552
Lancet Infect Dis. 2020 Apr;20(4):411-412
pubmed: 32105638
Lancet Infect Dis. 2020 May;20(5):533-534
pubmed: 32087114
Euro Surveill. 2020 Apr;25(14):
pubmed: 32290904
Nat Med. 2020 Jun;26(6):855-860
pubmed: 32322102
J Infect. 2020 Aug;81(2):260-265
pubmed: 32461062
Int J Environ Res Public Health. 2020 May 14;17(10):
pubmed: 32423150
Swiss Med Wkly. 2020 Mar 19;150:w20225
pubmed: 32191813
BMJ. 2020 Mar 22;368:m1163
pubmed: 32201376
medRxiv. 2020 Sep 09;:
pubmed: 32511523
Ann Med. 2020 Aug;52(5):207-214
pubmed: 32370561
BMJ. 2020 Mar 26;368:m1222
pubmed: 32217754
Lancet Respir Med. 2020 May;8(5):475-481
pubmed: 32105632
J Med Virol. 2020 Sep;92(9):1401-1403
pubmed: 32383171