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Abstract

Background

Universal SARS-CoV-2 testing at hospital admission has been proposed to prevent nosocomial transmission.

Aim

To investigate SARS-CoV-2 positivity in patients tested with low clinical COVID-19 suspicion at hospital admission.

Methods

We characterised a retrospective cohort of patients admitted to Karolinska University Hospital tested for SARS-CoV-2 by PCR from March to September 2020, supplemented with an in-depth chart review (16 March–12 April). We compared positivity rates in patients with and without clinical COVID-19 suspicion with Spearman’s rank correlation coefficient. We used multivariable logistic regression to identify factors associated with test positivity.

Results

From March to September 2020, 66.9% (24,245/36,249) admitted patient episodes were tested; of those, 61.2% (14,830/24,245) showed no clinical COVID-19 suspicion, and the positivity rate was 3.2% (469/14,830). There was a strong correlation of SARS-CoV-2 positivity in patients with low vs high COVID-19 suspicion (rho = 0.92; p < 0.001).

From 16 March to 12 April, the positivity rate was 3.9% (58/1,482) in individuals with low COVID-19 suspicion, and 3.1% (35/1,114) in asymptomatic patients. Rates were higher in women (5.0%; 45/893) vs men (2.0%; 12/589; p = 0.003), but not significantly different if pregnant women were excluded (3.7% (21/566) vs 2.2% (12/589); p = 0.09). Factors associated with SARS-CoV-2 positivity were testing of pregnant women before delivery (odds ratio (OR): 2.6; 95% confidence interval (CI): 1.3–5.4) and isolated symptoms in adults (OR: 3.3; 95% CI: 1.8–6.3).

Conclusions

This study shows a relatively high SARS-CoV-2 positivity rate in patients with low COVID-19 suspicion upon hospital admission. Universal SARS-CoV-2 testing of pregnant women before delivery should be considered.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2022-02-17
2024-04-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.7.2100079
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SARS-CoV-2 testing in patients with low COVID-19 suspicion at admission to a tertiary care hospital, Stockholm, Sweden, March to September 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Ana+Requena-M%C3%A9ndez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Requena-Méndez Ana</a>, <a href="/search?value1=Aikaterini+Mougkou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mougkou Aikaterini</a>, <a href="/search?value1=Pontus+Hedberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hedberg Pontus</a>, <a href="/search?value1=Suzanne+D+van+der+Werff&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van der Werff Suzanne D</a>, <a href="/search?value1=Hideyuki+Tanushi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tanushi Hideyuki</a>, <a href="/search?value1=Olof+Hertting&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hertting Olof</a>, <a href="/search?value1=Anna+F%C3%A4rnert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Färnert Anna</a>, <a href="/search?value1=Filippa+Nyberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nyberg Filippa</a>, <a href="/search?value1=Pontus+Naucler&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Naucler Pontus</a>, <a href="/search?value1=COVID-19-data-review+collaborators&option1=author&noRedirect=true" class="nonDisambigAuthorLink">COVID-19-data-review collaborators</a></span>. SARS-CoV-2 testing in patients with low COVID-19 suspicion at admission to a tertiary care hospital, Stockholm, Sweden, March to September 2020. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(7):pii=2100079. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.7.2100079" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.7.2100079</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 19 Jan 2021;&nbsp;&nbsp; <span class="generated">Accepted</span>: 05 May 2021 </span> </p>
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