Self-Assessed Severity as a Determinant of Coronavirus Disease 2019 Symptom Specificity: A Longitudinal Cohort Study

Author:

Bershteyn Anna1ORCID,Dahl Angela M2,Dong Tracy Q3,Deming Meagan E4,Celum Connie L5,Chu Helen Y6,Kottkamp Angelica C7,Greninger Alexander L38,Hoffman Risa M9,Jerome Keith R38,Johnston Christine M10,Kissinger Patricia J11,Landovitz Raphael J12,Laufer Miriam K4,Luk Alfred13,Neuzil Kathleen M4,Paasche-Orlow Michael K14,Pitts Robert A15,Schwartz Mark D1,Stankiewicz Karita Helen C16,Thorpe Lorna E1,Wald Anna3817,Zheng Crystal Y13,Wener Mark H8,Barnabas Ruanne V1819,Brown Elizabeth R220

Affiliation:

1. Department of Population Health, New York University Grossman School of Medicine , New York, New York , USA

2. Department of Biostatistics, University of Washington , Seattle, Washington , USA

3. Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center , Seattle, Washington , USA

4. Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA

5. International Clinical Research Center and Department of Global Health, University of Washington , Seattle, Washington , USA

6. Department of Medicine and Department of Epidemiology, University of Washington , Seattle, Washington , USA

7. Department of Medicine, New York University Grossman School of Medicine , New York, New York , USA

8. Department of Laboratory Medicine and Pathology, University of Washington , Seattle, Washington , USA

9. Department of Medicine and Division of Infectious Diseases, University of California , Los Angeles, California , USA

10. Department of Medicine and Department of Laboratory Medicine and Pathology, University of Washington , Seattle, Washington , USA

11. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine , New Orleans, Louisiana , USA

12. Center for Clinical AIDS Research & Education, University of California , Los Angeles, California , USA

13. John W. Deming Department of Medicine, Tulane University School of Medicine , New Orleans, Louisiana , USA

14. Department of Medicine and Boston Medical Center, Boston University School of Medicine , Boston, Massachusetts , USA

15. Department of Medicine and Division of Infectious Diseases, NYC Health & Hospitals/Bellevue , New York, New York , USA

16. Department of Medicine, University of Washington , Seattle, Washington , USA

17. Department of Medicine, Department of Epidemiology , Seattle, Washington , USA

18. Department of Global Health and Department of Medicine, University of Washington , Seattle, Washington , USA

19. Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA and

20. Vaccine and Infectious Disease Division and Public Health Sciences Division, Fred Hutchinson Cancer Research Center , USA

Abstract

Abstract Coronavirus disease 2019 symptom definitions rarely include symptom severity. We collected daily nasal swab samples and symptom diaries from contacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) case patients. Requiring ≥1 moderate or severe symptom reduced sensitivity to predict SARS-CoV-2 shedding from 60.0% (95% confidence interval [CI], 52.9%−66.7%) to 31.5% (95% CI, 25.7%− 38.0%) but increased specificity from 77.5% (95% CI, 75.3%−79.5%) to 93.8% (95% CI, 92.7%−94.8%).

Funder

Bill and Melinda Gates Foundation

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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