Diagnostic yield of screening for SARS-CoV-2 among patients admitted to hospital for alternate diagnoses: an observational cohort study

ObjectivesTo determine the diagnostic yield of screening patients for SARS-CoV-2 who were admitted with a diagnosis unrelated to COVID-19 and to identify risk factors for positive tests.DesignCohort from the Canadian COVID-19 Emergency Department Rapid Response Network registry.Setting30 acute care...

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Published inBMJ open Vol. 12; no. 8; p. e057852
Main Authors Davis, Philip, Rosychuk, Rhonda, Hau, Jeffrey P, Cheng, Ivy, McRae, Andrew D, Daoust, Raoul, Lang, Eddy, Turner, Joel, Khangura, Jaspreet, Fok, Patrick T, Stachura, Maja, Brar, Baljeet, Hohl, Corinne M
Format Journal Article
LanguageEnglish
Published London British Medical Journal Publishing Group 01.08.2022
BMJ Publishing Group LTD
BMJ Publishing Group
SeriesOriginal research
Subjects
Asymptomatic
Chronic obstructive pulmonary disease
Clinical outcomes
Cohort analysis
Coronaviruses
COVID-19
COVID-19 diagnostic tests
Data collection
Diagnostic microbiology
Emergency Medicine
EPIDEMIOLOGY
Hospitals
Medical diagnosis
Observational studies
Organisation of health services
Pandemics
Patients
Personal protective equipment
Pneumonia
Population
Severe acute respiratory syndrome coronavirus 2
Variables
Canada
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Summary:ObjectivesTo determine the diagnostic yield of screening patients for SARS-CoV-2 who were admitted with a diagnosis unrelated to COVID-19 and to identify risk factors for positive tests.DesignCohort from the Canadian COVID-19 Emergency Department Rapid Response Network registry.Setting30 acute care hospitals across Canada.ParticipantsPatients hospitalised for non-COVID-19-related diagnoses who were tested for SARS-CoV-2 between 1 March and 29 December 2020.Main outcomePositive nucleic acid amplification test for SARS-CoV-2.Outcome measureDiagnostic yield.ResultsWe enrolled 15 690 consecutive eligible adults who were admitted to hospital without clinically suspected COVID-19. Among these patients, 122 tested positive for COVID-19, resulting in a diagnostic yield of 0.8% (95% CI 0.64% to 0.92%). Factors associated with a positive test included presence of fever, being a healthcare worker, having a positive household contact or institutional exposure, and living in an area with higher 7-day average incident COVID-19 cases.ConclusionsUniversal screening of hospitalised patients for COVID-19 across two pandemic waves had a low diagnostic yield and should be informed by individual-level risk assessment in addition to regional COVID-19 prevalence.Trial registration numberNCT04702945.
Bibliography:Original research
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2021-057852