Rapid Diagnostic Appraisal of COVID-19 Could Prevent Spread Among Healthcare Workers

Sarasota, FL (WorkersCompenstion.com) – Early identification and control of healthcare workers with COVID-19 can lead to better protection for their coworkers and patients. Researchers in Belgium may have found a way to do that.

Certain patterns of symptoms may help detect the likely presence of the virus, leading to early quarantining of those affected. While diagnostic tests are imperative, pinpointing clinical characteristics of the virus can be another tool to help stem transmission.

“Where each individual symptom contributes to the clinical evaluation of possible infection, it is the combination of COVID-19 symptoms that could allow for a rapid diagnostic appraisal of the disease in a high prevalence setting,” the authors wrote. “Early transmission control is important at the onset of an epidemic.”

The researchers screened clinical characteristics of the coronavirus among healthcare workers with mild symptoms of an acute respiratory tract infection at a Belgium hospital, from March 9 to April 17. They also analyzed nasopharyngeal swabs of the workers. Their findings were published in the January edition of the Journal of Occupational and Environmental Medicine.

Half of 373 workers with symptoms tested positive for COVID-19. Their symptoms that were shown to be significantly higher than among those who tested negative included:

• Cough – 82 percent
• Headache – 78 percent
• Myalgia, or muscle pain – 70 percent
• Loss of smell or taste – 40 percent
• Fever of at least 99.5F

The idea of the study was not to look at the prevalence of the different symptoms, but to see the predictive value of certain symptoms suggestive for COVID-19. The researchers wanted to assess the symptoms most likely to contribute to a fast appraisal of potentially infected healthcare workers and provide early warning information.

“Significant higher prevalence among COVID-19 positive tested hospital workers were found for cough (82.2% vs 65.6%), headache (78.4% vs 62.4%), myalgia (70.3% vs 51.6%), loss of smell/taste (39.7% vs 10.3%), and fever more than or equal to 37.5 °C (99.5F) (75.7% vs 67.1%),” according to the findings.

The authors found variations among the symptoms, based on the ages and genders of the workers. For example, fatigue was associated with 90 percent of men who tested positive, but 71.9 percent for women.

The loss of smell/taste was most prevalent among younger hospital workers. It was present for 50 percent of workers under the age of 30, while for those in the 50 – 59 age group it was seen 32.3 percent of the time.

Myalgia was highest among those aged 50 to 59, and lowest among those under 30.

Workers under 30 who tested positive for COVID-19 were more likely to have typical cold symptoms – runny or stuffy nose, sore throat and sneezing.

The study also found an absence of fever in COVID-19 cases more so than in infections caused by other coronaviruses. “Whereas the initial focus of case detection was on patients with fever, we now understand that infected cases can present with mild respiratory symptoms without fever,” it said. “Early infections with atypical presentations may have been missed.”

Overall, “cough, headache, myalgia, loss of smell and fever were more common among COVID-19 positive versus COVID-19 negative tested cases,” the researchers said.

The day prior to and the initial days of symptom onset are when viral loads in the upper respiratory tract are highest, the authors said. Having a more rapid clinical diagnosis could prevent further transmission of the disease by isolating workers sooner.

“Developing an appropriate digital diagnostic strategy for healthcare workers such as an institutionalized real time data evaluation of suggestive symptoms for COVID-19 could allow for a rapid diagnostic appraisal,” the study said. “A personalized early warning system based on adequate detection of changes in several clinical parameters is crucial to mitigate further spread at the onset of the disease.”

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