Elsevier

The Lancet Digital Health

Volume 2, Issue 6, June 2020, Pages e323-e330
The Lancet Digital Health

Articles
Assessing risk factors for SARS-CoV-2 infection in patients presenting with symptoms in Shanghai, China: a multicentre, observational cohort study

https://doi.org/10.1016/S2589-7500(20)30109-6Get rights and content
Under a Creative Commons license
open access

Summary

Background

The outbreak of COVID-19 has led to international concern. We aimed to establish an effective screening strategy in Shanghai, China, to aid early identification of patients with COVID-19.

Methods

We did a multicentre, observational cohort study in fever clinics of 25 hospitals in 16 districts of Shanghai. All patients visiting the clinics within the study period were included. A strategy for COVID-19 screening was presented and then suspected cases were monitored and analysed until they were confirmed as cases or excluded. Logistic regression was used to determine the risk factors of COVID-19.

Findings

We enrolled patients visiting fever clinics from Jan 17 to Feb 16, 2020. Among 53 617 patients visiting fever clinics, 1004 (1·9%) were considered as suspected cases, with 188 (0·4% of all patients, 18·7% of suspected cases) eventually diagnosed as confirmed cases. 154 patients with missing data were excluded from the analysis. Exposure history (odds ratio [OR] 4·16, 95% CI 2·74–6·33; p<0·0001), fatigue (OR 1·56, 1·01–2·41; p=0·043), white blood cell count less than 4 × 109 per L (OR 2·44, 1·28–4·64; p=0·0066), lymphocyte count less than 0·8 × 109 per L (OR 1·82, 1·00–3·31; p=0·049), ground glass opacity (OR 1·95, 1·32–2·89; p=0·0009), and having both lungs affected (OR 1·54, 1·04–2·28; p=0·032) were independent risk factors for confirmed COVID-19.

Interpretation

The screening strategy was effective for confirming or excluding COVID-19 during the spread of this contagious disease. Relevant independent risk factors identified in this study might be helpful for early recognition of the disease.

Funding

National Natural Science Foundation of China.

Cited by (0)

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Contributed equally as co-first authors

Contributed equally