Clinical and laboratory characteristics in outpatient diagnosis of COVID-19 in healthcare professionals in Rio de Janeiro, Brazil

  1. Luis Cristovao Porto
  2. Claudia H Costa
  3. Alessandra S Nunes
  4. Isabel Bouzas
  5. Tiago F Ferreira
  6. Vinicius M Porto
  7. Danielle A Secco
  8. Sandra Vilas Boas
  9. Anamelia Costa Faria
  10. Rogerio Rufino

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Abstract

This study aimed to identify the symptoms associated with early stage SARS-CoV-2 (COVID-19) infections in healthcare professionals (HCPs) using both clinical and laboratory data.

Methods

A total of 1297 patients, admitted between 18 March and 8 April 2020, were stratified according to their risk of developing COVID-19 using their responses to a questionnaire designed to evaluate symptoms and risk conditions.

Results

Anosmia/hyposmia (p<0.0001), fever (p<0.0001), body pain (p<0.0001) and chills (p=0.001) were all independent predictors for COVID-19, with a 72% estimated probability for detecting COVID-19 in nasopharyngeal swab samples. Leucopenia, relative monocytosis, decreased eosinophil values, C reactive protein (CRP) and platelets were also shown to be significant independent predictors for COVID-19.

Conclusions

The significant clinical features for COVID-19 were identified as anosmia, fever, chills and body pain. Elevated CRP, leucocytes under 5400×10 9 /L and relative monocytosis (>9%) were common among patients with a confirmed COVID-19 diagnosis. These variables may help, in the absence of reverse transcriptase PCR tests, to identify possible COVID-19 infections during pandemic outbreaks.

Summary

From 19 March to 8 April 2020, 1297 patients attended the Polyclinic Piquet Carneiro for COVID-19 detection. HCP data were analysed, and significant clinical features were anosmia, fever, chills and body pain. Elevated CRP, leucopenia and monocytosis were common in COVID-19.

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  1. ScreenIT

    SciScore for 10.1101/2020.10.22.20217851: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the Local and National Ethics Committee (CAAE: 30135320.0.0000.5259).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The complete blood counts were carried out using a SYSMEX XT1800i, while the C-reactive protein (CRP; immunoturbidimetric), creatinine (CR, picrate kinetic), lactate dehydrogenase (LDH; IFCC), aspartate and alanine aminotransferases (AST and ALT; NAPH), and creatine phosphokinase (CK; N-acetyl L-cysteine) assays were performed using the Architect c8000 Equipment from Abbott.
    Abbott
    suggested: (Abbott, RRID:SCR_010477)
    All analyses were performed using the SPSS 26.0 software.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has several limitations associated with the fact that it is a cross-sectional, ongoing study, with an increasing number of patients. Although limited in number, data here may support other studies so that in the long term a better meta-analysed prediction system can be developed. The HCP population is predominantly made up of younger people and this may cause differences in the observations of this study versus studies conducted in older populations.[22 ,23] Currently, laboratory-based RT-PCR is the recommended test for diagnoses of acute cases to ensure patients can be identified and isolated and to facilitate the public health response, as reviewed by Venter and Richter {Venter, 2020 #1796}. On the other hand, The false-negative rate has important ramifications for gaining accurate clinical and epidemiological data and false-negative results may lead to misdiagnoses in both patients and HCP, with increased risk of infection transmission {Payne, 2020 #1795}. So, combining routine laboratory test that can detect both acute phase proteins and specific altered leukocyte profile corresponding to COVID-19 infection could add parameters to more efficient control of suspected individuals. Nonetheless, the rapid development of point-of-care molecular or antigen tests are already a reality {Lippi, 2020 #1468} Up to May. 2020, the clinical diagnosis and medical intervention for COVID-19 has been restricted in HCP servicing the military, civil, and federal police reaching 1,...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1136/jclinpath-2020-206797
  3. Version published to 10.1101/2020.10.22.20217851v1 on medRxiv