Hubert Blain1, Lucie Gamon2, Edouard Tuaillon3, Amandine Pisoni3, Nadia Giacosa1, Mylène Albrand1, Stéphanie Miot1,4, Yves Rolland5, Marie-Christine Picot2, Jean Bousquet6,7,8. 1. Department of Geriatrics, Montpellier University Hospital, Montpellier University, France. 2. Department of Medical Information, University Hospital of Montpellier, University of Montpellier, France. 3. Department of Virology, Montpellier University Hospital, INSERM 1058, Montpellier University, France. 4. CESP, INSERM U1178, Centre de recherche en Epidemiologie et Santé des Populations, Paris, France. 5. Gérontopôle de Toulouse, INSERM 1027; 31059 Toulouse, France. 6. Charité, Univeersitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany. 7. MACVIA-France, Montpellier, France. 8. University Hospital, Montpellier, France.
Abstract
BACKGROUND: Frail older persons may have an atypical presentation of coronavirus disease 2019 (COVID-19). The value of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) testing for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nursing homes (NHs) residents is not known. OBJECTIVE: To determine whether (i) atypical symptoms may predict rRT-PCR results and (ii) rRT-PCR results may predict immunisation against SARS-CoV-2 in NH residents. DESIGN: A retrospective longitudinal study. SETTING: Eight NHs with at least 10 rRT-PCR-positive residents. SUBJECTS: A total of 456 residents. METHODS: Typical and atypical symptoms recorded in residents' files during the 14 days before and after rRT-PCR testing were analysed. Residents underwent blood testing for IgG-SARS-CoV-2 nucleocapsid protein 6 to 8 weeks after testing. Univariate and multivariate analyses compared symptoms and immunisation rates in rRT-PCR-positive and negative residents. RESULTS: A total of 161 residents had a positive rRT-PCR (35.3%), 17.4% of whom were asymptomatic before testing. Temperature >37.8°C, oxygen saturation <90%, unexplained anorexia, behavioural change, exhaustion, malaise and falls before testing were independent predictors of a further positive rRT-PCR. Among the rRT-PCR-positive residents, 95.2% developed SARS-CoV-2 antibodies vs 7.6% in the rRT-PCR-negative residents. Among the residents with a negative rRT-PCR, those who developed SARS-CoV-2 antibodies more often had typical or atypical symptoms (P = 0.02 and <0.01, respectively). CONCLUSION: This study supports a strategy based on (i) testing residents with typical or unexplained atypical symptoms for an early identification of the first SARS-CoV-2 cases, (ii) rT-PCR testing for identifying COVID-19 residents, (iii) repeated wide-facility testing (including asymptomatic cases) as soon as a resident is tested positive for SARS-CoV-2 and (iv) implementing SARS-CoV-2 infection control measures in rRT-PCR-negative residents when they have unexplained typical or atypical symptoms.
BACKGROUND: Frail older persons may have an atypical presentation of coronavirus disease 2019 (COVID-19). The value of real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) testing for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nursing homes (NHs) residents is not known. OBJECTIVE: To determine whether (i) atypical symptoms may predict rRT-PCR results and (ii) rRT-PCR results may predict immunisation against SARS-CoV-2 in NH residents. DESIGN: A retrospective longitudinal study. SETTING: Eight NHs with at least 10 rRT-PCR-positive residents. SUBJECTS: A total of 456 residents. METHODS: Typical and atypical symptoms recorded in residents' files during the 14 days before and after rRT-PCR testing were analysed. Residents underwent blood testing for IgG-SARS-CoV-2 nucleocapsid protein 6 to 8 weeks after testing. Univariate and multivariate analyses compared symptoms and immunisation rates in rRT-PCR-positive and negative residents. RESULTS: A total of 161 residents had a positive rRT-PCR (35.3%), 17.4% of whom were asymptomatic before testing. Temperature >37.8°C, oxygen saturation <90%, unexplained anorexia, behavioural change, exhaustion, malaise and falls before testing were independent predictors of a further positive rRT-PCR. Among the rRT-PCR-positive residents, 95.2% developed SARS-CoV-2 antibodies vs 7.6% in the rRT-PCR-negative residents. Among the residents with a negative rRT-PCR, those who developed SARS-CoV-2 antibodies more often had typical or atypical symptoms (P = 0.02 and <0.01, respectively). CONCLUSION: This study supports a strategy based on (i) testing residents with typical or unexplained atypical symptoms for an early identification of the first SARS-CoV-2 cases, (ii) rT-PCR testing for identifying COVID-19 residents, (iii) repeated wide-facility testing (including asymptomatic cases) as soon as a resident is tested positive for SARS-CoV-2 and (iv) implementing SARS-CoV-2 infection control measures in rRT-PCR-negative residents when they have unexplained typical or atypical symptoms.
Authors: Bastien Reyné; Christian Selinger; Mircea T Sofonea; Stéphanie Miot; Amandine Pisoni; Edouard Tuaillon; Jean Bousquet; Hubert Blain; Samuel Alizon Journal: Int J Epidemiol Date: 2021-06-21 Impact factor: 9.685
Authors: Philip W Rouadi; Samar A Idriss; Jean Bousquet; Tanya M Laidlaw; Cecilio R Azar; Mona S Al-Ahmad; Anahi Yañez; Maryam Ali Y Al-Nesf; Talal M Nsouli; Sami L Bahna; Eliane Abou-Jaoude; Fares H Zaitoun; Usamah M Hadi; Peter W Hellings; Glenis K Scadding; Peter K Smith; Mario Morais-Almeida; René Maximiliano Gómez; Sandra N Gonzalez Diaz; Ludger Klimek; Georges S Juvelekian; Moussa A Riachy; Giorgio Walter Canonica; David Peden; Gary W K Wong; James Sublett; Jonathan A Bernstein; Lianglu Wang; Luciana K Tanno; Manana Chikhladze; Michael Levin; Yoon-Seok Chang; Bryan L Martin; Luis Caraballo; Adnan Custovic; Jose Antonio Ortega-Martell; Erika Jensen-Jarolim; Motohiro Ebisawa; Alessandro Fiocchi; Ignacio J Ansotegui Journal: World Allergy Organ J Date: 2021-11-22 Impact factor: 4.084
Authors: Adam H Dyer; Aoife Fallon; Claire Noonan; Helena Dolphin; Cliona O'Farrelly; Nollaig M Bourke; Desmond O'Neill; Sean P Kennelly Journal: J Am Med Dir Assoc Date: 2022-07-04 Impact factor: 7.802
Authors: Bastien Reyné; Christian Selinger; Mircea T Sofonea; Stéphanie Miot; Amandine Pisoni; Edouard Tuaillon; Jean Bousquet; Hubert Blain; Samuel Alizon Journal: Int J Epidemiol Date: 2021-06-21 Impact factor: 7.196