RT Journal Article
SR Electronic
T1 Clinical and serological profile of asymptomatic and non-severe symptomatic COVID-19 cases: Lessons from primary care in Latin America
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen20X101137
DO 10.3399/bjgpopen20X101137
A1 Klaus Puschel
A1 Catterina Ferreccio
A1 Blanca Peñaloza
A1 Katia Abarca
A1 Maria-Paulina Rojas
A1 Alvaro Tellez
A1 Philippa Moore
A1 Ana Maria Cea
A1 Carlos Wilson
A1 Vicente Cid
A1 Joaquin Montero
YR 2020
UL http://bjgpopen.org/content/early/2020/11/12/bjgpopen20X101137.abstract
AB Background: Chile, presents one of the highest incidences of Covid-19 infection in the world. Primary care can play a key role in early detection and contention of the disease. There is lack of information on the clinical profile of suspected Covid-19 primary care patients and controversy on the effectiveness of rapid serologic tests in the diagnosis and surveillance of the disease. Aim: To assess the effectiveness of rapid serologic testing in detection and surveillance of Covid-19 cases in primary care. Design and Setting: Longitudinal study based on non-random sample of 522 participants including 304 symptomatic patients and 218 high-risk asymptomatic individuals receiving care at four primary health clinics in an underserved area in Santiago. Method: Participants were systematically assessed and tested for Covid-19 with RT-PCR and serology at baseline and followed clinically and serologically for a three weeks period. Results: The prevalence rate of RT-PCR confirmed Covid-19 cases was 3.5 times higher in symptomatic patients (27.5% (22.1-32.8; 95% CI) compared to asymptomatic participants (7.9% (4.3-11.6; 95% CI). Similarly, the immune response was significantly different between both groups. Sensitivity of serologic testing was 57.8% (44.8-70.1; 95% CI) during the third week of follow-up and specificity was 98.4% (95.5-99.7; 95% CI). Conclusion: Rapid serologic testing is ineffective for detecting asymptomatic or non-severe cases of COVID-19 at early stages of the disease but can be of value for surveillance of immunity response in primary care. The clinical profile and immune response of Covid-19 patients in primary care differ from those in hospital-based populations.