Public health and clinical approach to proactive prevalence of symptoms-based diagnosis of mild sarsCoV-2 infection in southern tuscany
Keywords:
COVID-19, SARS-CoV-2 infection, study, epidemiology, pharyngeal swab, prevalence, incidenceAbstract
Background. To date, it is unknown how many Italians have had or have a mild sars-CoV-2 infection, because of the lack of epidemiological studies involving the general population.
Study design. Aim of this study was to investigate the prevalence/incidence of a symptoms-based mild sarsCoV-2 infection in southern Tuscany, by using an online survey.
Methods. An anonymous random middle-aged sample of 3,460 individuals completed the survey. A symptomscore ≥5, calculated on 195 patients with RT-PCR COVID-19 disease (sensitivity/specificity of 0.815/0.780 respectively) was used for the diagnosis.
Results. This cut-off highlighted that 12.3% of all the population might have had a sars-CoV-2 infection, while 3.9% of them might have it at the time of the survey. Female sex (OR=1.334 [1.029-1.728]; p=0.030), obesity status (OR=1.961 [1.304-2.949]; p=0.001), asthma (OR=2.035 [1.433-2.890]; p=0.0001), autoimmune diseases (OR=2.103 [1.381-3.201]; p=0.001), were all risk factors for showing mild sars-CoV-2 infection. Instead, the elderly had a low probability to develop mild forms of the disease (OR=0.984 [0.9750.994]; p=0.001).
Conclusion: A remarkable number of subjects in Southern Tuscany may have already had a mild SARSCoV-2 infection. Symptoms scores might be used to screen subjects with a suspected infection. Female sex, obesity, asthma, autoimmune diseases may be factors linked with mild forms of COVID-19 disease.
References
1. Signorelli C, Scognamiglio T, Odone A. COVID19 in Italy: impact of containment measures and prevalence estimates of infection in the general population. Acta Biomed 2020; 91(3-S): 175-9. doi: 10.23750/abm.v91i3-S.9511.
2. Adorni F, Prinelli F, Bianchi F, et al. SelfReported Symptoms of SARS-CoV-2 Infection in a Nonhospitalized Population in Italy: CrossSectional Study of the EPICOVID19 Web-Based Survey. JMIR Public Health Surveill 2020 Sep 18; 6(3): e21866. doi: 10.2196/21866.
3. Mudatsir M, Fajar JK, Wulandari L, et al. Predictors of COVID-19 severity: a systematic review and meta-analysis [version 2; peer review: 2 approved]. F1000Res 2021; 9: 1107. https://doi. org/10.12688/f1000research.26186.2.
4. http://www.salute.gov.it/portale/nuovocoronavirus/dettaglioContenutiNuovoCoronavirus.jsp ?lingua=italiano&id=5337&area=nuovoCoron avirus&menu=vuoto [Last accessed: 2020, Sep 22].
5. Tostmann A, Bradley J, Bousema T, et al. Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020. Euro Surveill 2020; 25(16). doi: 10.2807/1560-7917.ES.2020.25.16.2000508.
6. Garg S, Kim L, Whitaker M, O’Halloran A, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 - COVID-NET, 14
States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69(15): 458-64. doi: 10.15585/ mmwr.mm6915e3.
7. Conti P, Younes A. Coronavirus COV-19/SARSCoV-2 affects women less than men: clinical response to viral infection. J Biol Regul Homeost Agents 2020; 34(2): 339-43. doi: 10.23812/ Editorial-Conti-3.
8. Zeng F, Dai C, Caiet al. A comparison study of SARS-CoV-2 IgG antibody between male and female COVID-19 patients: a possible reason underlying different outcome between sex. J Med Virol 2020; 92(10): 2054-4. doi: 10.1002/ jmv.25989. Epub 2020 May 8.
9. Caussy C, Wallet F, Laville M, Disse E. Obesity is associated with severe forms of COVID-19. Obesity (Silver Spring). 2020; 28(7): doi:
10.1002/oby.22842. Epub 2020 Apr 21.
10. The Lancet Respiratory Medicine. Reflecting on World Asthma Day in the era of COVID-19. Lancet Respir Med 2020; 8(5): 423. doi: 10.1016/ S2213-2600(20)30184-3. Epub 2020 Apr 23.
11. Kaye L, Theye B, Smeenk I, Gondalia R, Barrett MA, Stempel DA. Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic. J Allergy Clin Immunol Pract 2020; 8(7) 2384-5. doi:
10.1016/j.jaip.2020.04.053. Epub 2020 May 1.
12. Emmi G, Bettiol A, Mattioli I, et al. SARSCoV-2 infection among patients with systemic autoimmune diseases. Autoimmun Rev 2020; 19(7)102575. doi: 10.1016/j.autrev.2020.102575. Epub 2020 May 5.
13. Sposato B, Scalese M. Why do children seem to be more protected against COVID-19? A hypothesis. Med Hypotheses 2020; 143: 110151. doi: 10.1016/j.mehy.2020.110151.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.