Feasibility and effectiveness of daily temperature screening to detect COVID-19 in a prospective cohort at a large public university.
COVID-19
Detection
Fever
SARS-CoV-2
Screening
Temperature monitoring
Thermometer
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
16 09 2021
16 09 2021
Historique:
received:
28
04
2021
accepted:
29
08
2021
entrez:
17
9
2021
pubmed:
18
9
2021
medline:
23
9
2021
Statut:
epublish
Résumé
Many persons with active SARS-CoV-2 infection experience mild or no symptoms, presenting barriers to COVID-19 prevention. Regular temperature screening is nonetheless used in some settings, including university campuses, to reduce transmission potential. We evaluated the potential impact of this strategy using a prospective university-affiliated cohort. Between June and August 2020, 2912 participants were enrolled and tested for SARS-CoV-2 by PCR at least once (median: 3, range: 1-9). Participants reported temperature and symptoms daily via electronic survey using a previously owned or study-provided thermometer. We assessed feasibility and acceptability of daily temperature monitoring, calculated sensitivity and specificity of various fever-based strategies for restricting campus access to reduce transmission, and estimated the association between measured temperature and SARS-CoV-2 test positivity using a longitudinal binomial mixed model. Most participants (70.2%) did not initially have a thermometer for taking their temperature daily. Across 5481 total person months, the average daily completion rate of temperature values was 61.6% (median: 67.6%, IQR: 41.8-86.2%). Sensitivity for SARS-CoV-2 ranged from 0% (95% CI 0-9.7%) to 40.5% (95% CI 25.6-56.7%) across all strategies for self-report of possible COVID-19 symptoms on day of specimen collection, with corresponding specificity of 99.9% (95% CI 99.8-100%) to 95.3% (95% CI 94.7-95.9%). An increase of 0.1 °F in individual mean body temperature on the same day as specimen collection was associated with 1.11 increased odds of SARS-CoV-2 positivity (95% CI 1.06-1.17). Our study is the first, to our knowledge, that examines the feasibility, acceptability, and effectiveness of daily temperature screening in a prospective cohort during an infectious disease outbreak, and the only study to assess these strategies in a university population. Daily temperature monitoring was feasible and acceptable; however, the majority of potentially infectious individuals were not detected by temperature monitoring, suggesting that temperature screening is insufficient as a primary means of detection to reduce transmission of SARS-CoV-2.
Sections du résumé
BACKGROUND
Many persons with active SARS-CoV-2 infection experience mild or no symptoms, presenting barriers to COVID-19 prevention. Regular temperature screening is nonetheless used in some settings, including university campuses, to reduce transmission potential. We evaluated the potential impact of this strategy using a prospective university-affiliated cohort.
METHODS
Between June and August 2020, 2912 participants were enrolled and tested for SARS-CoV-2 by PCR at least once (median: 3, range: 1-9). Participants reported temperature and symptoms daily via electronic survey using a previously owned or study-provided thermometer. We assessed feasibility and acceptability of daily temperature monitoring, calculated sensitivity and specificity of various fever-based strategies for restricting campus access to reduce transmission, and estimated the association between measured temperature and SARS-CoV-2 test positivity using a longitudinal binomial mixed model.
RESULTS
Most participants (70.2%) did not initially have a thermometer for taking their temperature daily. Across 5481 total person months, the average daily completion rate of temperature values was 61.6% (median: 67.6%, IQR: 41.8-86.2%). Sensitivity for SARS-CoV-2 ranged from 0% (95% CI 0-9.7%) to 40.5% (95% CI 25.6-56.7%) across all strategies for self-report of possible COVID-19 symptoms on day of specimen collection, with corresponding specificity of 99.9% (95% CI 99.8-100%) to 95.3% (95% CI 94.7-95.9%). An increase of 0.1 °F in individual mean body temperature on the same day as specimen collection was associated with 1.11 increased odds of SARS-CoV-2 positivity (95% CI 1.06-1.17).
CONCLUSIONS
Our study is the first, to our knowledge, that examines the feasibility, acceptability, and effectiveness of daily temperature screening in a prospective cohort during an infectious disease outbreak, and the only study to assess these strategies in a university population. Daily temperature monitoring was feasible and acceptable; however, the majority of potentially infectious individuals were not detected by temperature monitoring, suggesting that temperature screening is insufficient as a primary means of detection to reduce transmission of SARS-CoV-2.
Identifiants
pubmed: 34530802
doi: 10.1186/s12889-021-11697-6
pii: 10.1186/s12889-021-11697-6
pmc: PMC8445011
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1693Informations de copyright
© 2021. The Author(s).
Références
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
BMJ. 2017 Dec 13;359:j5468
pubmed: 29237616
Euro Surveill. 2009 Feb 12;14(6):
pubmed: 19215720
J Appl Physiol (1985). 1999 Jan;86(1):22-8
pubmed: 9887109
Science. 2020 Mar 13;367(6483):1177-1178
pubmed: 32165563
MMWR Morb Mortal Wkly Rep. 2020 Mar 27;69(12):347-352
pubmed: 32214086
Emerg Med Australas. 2020 Oct;32(5):867-869
pubmed: 32578926
West J Emerg Med. 2020 Jun 24;21(4):909-917
pubmed: 32726264
Health Psychol Rev. 2015;9(3):277-95
pubmed: 25207647
MMWR Morb Mortal Wkly Rep. 2020 Apr 03;69(13):377-381
pubmed: 32240128
Int J Nurs Pract. 2004 Oct;10(5):216-23
pubmed: 15461691
MMWR Morb Mortal Wkly Rep. 2020 Apr 10;69(14):411-415
pubmed: 32271722
Stat Med. 2007 May 10;26(10):2170-83
pubmed: 16927452
Public Health. 2015 Nov;129(11):1471-8
pubmed: 26296847
Chronobiol Int. 2019 Dec;36(12):1646-1657
pubmed: 31530024
Clin Med (Lond). 2020 Mar;20(2):124-127
pubmed: 32139372
Cogn Psychol. 2016 Nov;90:1-47
pubmed: 27567237
Trop Med Health. 2020 Mar 9;48:14
pubmed: 32165854
Prev Med. 2015 Jun;75:75-85
pubmed: 25843244
Int J Environ Res Public Health. 2019 Nov 21;16(23):
pubmed: 31766548
JAMA Netw Open. 2020 Jul 1;3(7):e2016818
pubmed: 32735339
Elife. 2020 Jan 07;9:
pubmed: 31908267
Infect Control Hosp Epidemiol. 2004 Dec;25(12):1109-11
pubmed: 15636300
Nat Biotechnol. 2020 Jul;38(7):791-797
pubmed: 32555529
Lancet Infect Dis. 2020 Aug;20(8):892-893
pubmed: 32628907
Open Forum Infect Dis. 2019 Apr 09;6(4):ofz032
pubmed: 30976605
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
Epidemiology. 2007 Nov;18(6):800-4
pubmed: 18049194
J Chin Med Assoc. 2020 Nov;83(11):997-1003
pubmed: 33165287
Emerg Infect Dis. 2015 Nov;21(11):1897-905
pubmed: 26484940
J Microbiol Immunol Infect. 2020 Jun;53(3):503-504
pubmed: 32331981