The major predictors of testing positive for COVID-19 among symptomatic hospitalized patients

barasa, s.

The major predictors of testing positive for COVID-19 among symptomatic hospitalized patients Samson Barasa,1 Amy Ballard,1 Josephine Kiage-Mokaya, 1 Michael Friedlander,1 Geraldine Luna,2 1PeaceHealth Sacred Heart 2University of Illinois at Chicago Introduction: Increasing corona virus disease 2019 (COVID-19) pre-test probability can minimize testing patients who are less likely to have COVID-19 and therefore reducing personal protective equipment and COVID-19 testing kit use. The aim of this study was to identify patients who were likely to test positive for COVID-19 among symptomatic patients suspected of having COVID-19 during hospitalization by comparing COVID-19 positive and negative patients. Method: We conducted a retrospective chart review of patients who were [≥]18 years old and underwent COVID-19 Polymerase chain reaction test because they presented with symptoms thought to be due to COVID-19. A Poisson regression analysis was conducted after clinical presentation, demographic, medical co-morbidities, laboratory and chest image data was retrieved from the medical records. Results: Charts of 277 and 18 COVID-19 negative and positive patients respectively were analyzed. Dyspnea (61%) was the most common symptom among COVID-19 negative patients, while 72% and 61% COVID-19 positive patients had cough and fever respectively. COVID-19 positive patients were more likely to present initially with cough [1.082 (1.022 - 1.145)], fever [1.066 (1.014 - 1.121)] and be 50 to 69 years old [1.094 (1.021 - 1.172)]. Dyspnea, weakness, lymphopenia and bilateral chest image abnormality were not associated with COVID-19 positivity. COVID-19 positive patients were less likely to have non-COVID-19 respiratory viral illness [1.068 (1.019 - 1.119)], human immunodeficiency virus [0.849 (0.765 - 0.943)] and heart failure history [0.093 (0.891 - 0.978)]. Other chronic medical problems (hypertension, diabetes mellitus, chronic obstructive pulmonary disease and coronary artery disease) were not associated with testing positive for COVID-19. Conclusion: Cough, fever and being 50 to 69 years old are better predictors of symptomatic COVID-19 positivity during hospitalization. Despite published studies reporting a high prevalence of lymphopenia among COVID-19 positive patients, lymphopenia is not associated with the risk of testing positive for COVID-19. Key Words: COVID-19, Predictors, Symptomatic, Hospitalized