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Abstract
Aims 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 5400×109/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.
- diagnosis
- viruses
- leucocytes
- biochemistry
- diagnostic screening programmes
Data availability statement
Data are available on reasonable request. All data relevant to the study are included in the article. Data are not in a repository. Signs and symptoms, comorbidities and laboratory results may be available in a deidentified participant data.
This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
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Data availability statement
Data are available on reasonable request. All data relevant to the study are included in the article. Data are not in a repository. Signs and symptoms, comorbidities and laboratory results may be available in a deidentified participant data.
Footnotes
Handling editor Tahir S Pillay.
Collaborators PPC-UERJ against COVID-19 Group: Rosangela Gomes Martins (Research Division, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro); Cíntia Duarte (Nurse Department, Polyclinic Piquet Carneiro, Rio de Janeiro State University,Rio de Janeiro); Elizabeth Bittencourt (Administrative and Finance Services, Polyclinic Piquet Carneiro, Rio de Janeiro, State University, Rio de Janeiro); Anderson Loureiro (Pharmacy and Supply Service, Polyclinic Piquet Carneiro, Rio de Janeiro State, University, Rio de Janeiro); Angela Maria Santos (Histocompatibility and Cryopreservation Laboratory, Institute of Biology Roberto, Alcantara Gomes, Rio de Janeiro State University, Rio de Janeiro); Vania Souza (Clinical Pathology Service, Polyclinic Piquet Carneiro, Rio de Janeiro State, University, Rio de Janeiro); Fernanda Silva, Maria Cristina Lopes (Nurse Department, Polyclinic Piquet Carneiro, Rio de Janeiro State University, Rio de Janeiro); Marcelle Castro (Histocompatibility and Cryopreservation Laboratory, Institute of Biology Roberto, Alcantara Gomes, Rio de Janeiro State University, Rio de Janeiro); Areta Silva, Flavia Vasconcelos (Clinical Pathology Service, Polyclinic Piquet Carneiro, Rio de Janeiro State, University, Rio de Janeiro); Diego Moreira (Nurse Department, Polyclinic Piquet Carneiro, Rio de Janeiro State University, Rio de Janeiro); Juliana Motta (Histocompatibility and Cryopreservation Laboratory, Institute of Biology Roberto, Alcantara Gomes, Rio de Janeiro State University, Rio de Janeiro); Cristiano Lima (Clinical Pathology Service, Polyclinic Piquet Carneiro, Rio de Janeiro State, University, Rio de Janeiro); Raphaela Menezes, Nathalia Brazão, Jeane Nogueira, Ana Paula VIllela Silva, Ingrid Abreu-Brito, Scarlathe Costa, Roberta Lemes, Jessica dePaula, Giovanna Bongionanni, Ohana Bezerra, Valter Andrade-Neto (Histocompatibility and Cryopreservation Laboratory, Institute of Biology Roberto, Alcantara Gomes, Rio de Janeiro State University, Rio de Janeiro); Leonardo Morette (Clinical Pathology Service, Polyclinic Piquet Carneiro, Rio de Janeiro State, University, Rio de Janeiro); Rafael Barbosa, Jose Sanches (Logistic, Informatic and Infrastructure Service, Polyclinic Piquet Carneiro, Rio, de Janeiro State University, Rio de Janeiro); Pedro Melo (Laboratory of Biomedical Instrumentation, Institute of Biology Roberto Alcantara, Gomes, Rio de Janeiro State University, Rio de Janeiro); Sergio Freire (Information Technology and Education in Health Department, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro); Romulo Souza (Communication and Human Resource Service, Polyclinic Piquet Carneiro, Rio de Janeiro State University, Rio de Janeiro); Laiz Gomes (Health Research Support Facility Center (CAPCS), Polyclinic Piquet Carneiro, Rio de Janeiro State University, Rio de Janeiro); Denize Felizardo, Alexsandre Rodrigues (Administrative and Finance Services, Polyclinic Piquet Carneiro, Rio de Janeiro State University, Rio de Janeiro); Priscila Franco, Renata Miranda (Communication and Human Resource Service, Polyclinic Piquet Carneiro, Rio de Janeiro State University, Rio de Janeiro).
Contributors Study conception and design: LCP, RR, CHC, ASN and IB. Interview, consultation and patient orientation and nasopharyngeal swab (NPS) and blood sampling: ASN, TFF, ACF, FS, CD, SVB. Laboratory testing and interpretation: DAS, AMS, RM, VS, VMP, JM, APVS, MC, JN, FV, AS, CL, NB, IA-B, SC, RL, JdP, GB, OB, VA-N and LM. Electronic data acquisition: SF, IB and RS. Logistic, communication and supply services: EB, AL, RB, JS, DF, AR, PF and RM. Analysis of data and figures: RGM, IB, RR, CHC and LCP. Interpretation of data: IB, RR, CHC and LCP. Drafting of manuscript: LCP, RR and CHC. Critical revision: CHC and IB. All authors approved the final manuscript.
Funding The Laboratory of Histocompatibility and Cryopreservation received a thermocycler and a −80°C freezer from COVID-19 donation open account for Pedro Ernesto University Hospital. Rio de Janeiro Health Secretary provided nucleic acid extraction and reverse transcription PCR kits.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.