Infectious Disease
Under-examining patients with febrile illness may have contributed to an increase in COVID-19
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Pletcher does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.
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A study of more than 2,600 adults in the US found “generally low COVID-19 test rates” in participants who reported the onset of a febrile illness by the end of October 2020, according to results published on JAMA Network Open.
“We cannot know for sure what impact targeting coronavirus tests more effectively would have on disease transmission in the US, how it might have blunted the third wave that recently swept through the US, or how it might have reduced it the transmission of new coronavirus variants could be used ” Mark J. Pletcher, MD, MPH, Professor of Epidemiology and Biostatistics at the University of California’s San Francisco School of Medicine, and colleagues wrote. “It is clear, however, that countries like China and South Korea are taking a much more aggressive, targeted approach to testing and appear to have significantly lower transmission rates in the community.”
Source: Pletcher MJ et al. JAMA Netw Open. 2021; doi: 10.1001 / jamanetworkopen.2021.8500.
Pletcher and colleagues analyzed patient data from 2,679 people aged 18 and over who had a newly emerging febrile illness from April to October 2020 via the COVID-19 Citizen Science Study. They reviewed data from each patient’s survey related to COVID-19 symptoms and tests and named receiving the results of a coronavirus test within 7 days of the onset of the febrile illness as the primary outcome of the study.
A total of 3,865 new episodes of febrile illness occurred between April 2, 2020 and October 23, 2020. A total of 12% of participants said they had received a test result in a survey conducted 14 days after the fever began.
The time-to-event modeling performed by the researchers estimated that 7.5 days (95% CI, 19.1% -22%) of patients received a test result 7 days after the onset of febrile illness. This percentage increased from 9.8% (95% CI, 7.5% -12%) at the start of the COVID-19 outbreak to 24.1% (95% CI, 21.5% -26.7%) to End of July. However, testing rates did not increase significantly after July, and the rate was 25.9% (95% CI, 21.6% -30.3%) at the end of October, the researchers reported.
The researchers said they couldn’t tell whether test differences contributed to differences in COVID-19 results. Black participants had lower testing rates, but the difference did not reach statistical significance due to a small number of black participants in the study population.
“The results of this cohort study suggest that coronavirus tests are systematically inadequately used in patients with febrile illnesses. Whether this is due to lack of availability of tests, knowledge of how to obtain a test, understanding the importance of testing, or active avoidance (e.g. to avoid economic difficulties associated with isolating and quarantining contacts when one tests positive) is unclear. Pletcher and colleagues wrote.
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