Risk factors for a positive SARS-CoV-2 PCR in patients with common cold symptoms in a primary care setting – a retrospective analysis based on a joint documentation standard

Abstract Background Combating the COVID-19 pandemic is a major challenge for health systems, citizens and policy makers worldwide. Early detection of affected patients within the large and heterogeneous group of patients with common cold symptoms is an important element of this effort, but often hindered by limited testing resources, false-negative test results and the lack of pathognomonic symptoms in COVID-19. Therefore, we aimed to identify anamnestic items with an increased/decreased odds ratio for a positive SARS-CoV-2 PCR (CovPCR) result in a primary care setting. Methods We performed a multi-center cross-sectional cohort study on predictive clinical characteristics for a positive CovPCR over a period of 4 weeks in primary care patients in Germany. Results In total, 374 patients in 14 primary care centers received CovPCR and were included in this analysis. The median age was 44.0 (IQR: 31.0–59.0) and a fraction of 10.7% (n = 40) tested positive for COVID-19. Patients who reported anosmia had a higher odds ratio (OR: 4.54; 95%-CI: 1.51–13.67) for a positive test result while patients with a sore throat had a lower OR (OR: 0.33; 95%-CI: 0.11–0.97). Furthermore, patients who had a first grade contact with an infected persons and showed symptoms themselves also had an increased OR for positive testing (OR: 5.16; 95% CI: 1.72–15.51). This correlation was also present when they themselves were still asymptomatic (OR: 12.55; 95% CI: 3.97–39.67). Conclusions Several anamnestic criteria may be helpful to assess pre-test probability of COVID-19 in patients with common cold symptoms.

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Distinguishing between COVID-19 and the common cold in a primary care setting - comparison of patients with positive and negative SARS-CoV-2 PCR results

10.1101/2020.04.27.20081877 ◽

2020 ◽

Cited By ~ 1

Author(s):

Johannes Just ◽

Marie-Therese Puth ◽

Felix Regenold ◽

Klaus Weckbecker ◽

Markus Bleckwenn

Keyword(s):

Primary Care ◽

Sore Throat ◽

Common Cold ◽

First Grade ◽

Infected Person ◽

Cross Sectional ◽

Policy Makers ◽

Primary Care Patients ◽

The Common ◽

Predictive Risk

BackgroundCombating the COVID-19 pandemic is a major challenge for health systems, citizens and policy makers worldwide. Early detection of affected patients within the huge population of patients with common cold symptoms is an important element of this effort but often hindered by limited testing resources. We aimed to identify predictive risk profiles for a positive PCR result in primary care.MethodsMulti-center cross-sectional cohort study on predictive characteristics over a period of 4 weeks in primary care patients in Germany. We evaluated age, sex, reason for testing, risk factors, symptoms, and expected PCR result for their impact on the test 46 result.ResultsIn total, 374 patients in 14 primary care centers received SARS-CoV-2 PCR swab testing and were included in this analysis. A fraction of 10.7% (n=40) tested positive for COVID-19. Patients who reported anosmia had a higher odds ratio (OR: 4.54; 95%-CI: 1.51–13.67) for a positive test result while patients with a sore throat had a lower OR (OR: 0.33; 95%-CI: 0.11–0.97). Patients who had a first grade contact with an infected persons and showed symptoms themselves also had an increased OR for positive testing (OR: 5.16; 95% CI: 1.72–15.51). This correlation was also present when they themselves were still asymptomatic (OR: 12.55; 95% CI: 3.97–39.67).ConclusionThe reported contact to an infected person is the most important factor for a positive PCR result, independent of any symptoms of illness in the tested patient. Those persons with contact to an infected person should always get a PCR test. If no contact is reported and testing material is scarce, anosmia should increase the likelihood of performing a test, while a sore throat should decrease it.

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Chronic pain in type 2 diabetic patients: A cross-sectional study in primary care setting

European Journal of General Practice ◽

10.3109/13814788.2014.887674 ◽

2014 ◽

Vol 20 (4) ◽

pp. 260-267 ◽

Cited By ~ 12

Author(s):

Orly Liberman ◽

Roni Peleg ◽

Pesach Shvartzman

Keyword(s):

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Type 2 Diabetic

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Risk factors for foot ulcers—A cross sectional survey from a primary care setting in Brazil

Primary Care Diabetes ◽

10.1016/j.pcd.2013.04.003 ◽

2014 ◽

Vol 8 (1) ◽

pp. 71-76 ◽

Cited By ~ 14

Author(s):

Maira Sayuri Sakay Bortoletto ◽

Selma Maffei de Andrade ◽

Tiemi Matsuo ◽

Maria do Carmo Lourenço Haddad ◽

Alberto Durán González ◽

...

Keyword(s):

Risk Factors ◽

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Foot Ulcers ◽

Cross Sectional Survey ◽

Cross Sectional

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Potentially inappropriate medication use among geriatric patients in primary care setting: A cross-sectional study using the Beers, STOPP, FORTA and MAI criteria

PLoS ONE ◽

10.1371/journal.pone.0218174 ◽

2019 ◽

Vol 14 (6) ◽

pp. e0218174 ◽

Cited By ~ 5

Author(s):

Abdelmoneim Awad ◽

Olivia Hanna

Keyword(s):

Primary Care ◽

Geriatric Patients ◽

Care Setting ◽

Primary Care Setting ◽

Inappropriate Medication ◽

Medication Use ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Inappropriate Medication Use

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Increased Cardiovascular Disease in Patients with Inflammatory Arthritis in Primary Care: A Cross-sectional Observation: Table 1.

The Journal of Rheumatology ◽

10.3899/jrheum.090010 ◽

2009 ◽

Vol 36 (9) ◽

pp. 1866-1868 ◽

Cited By ~ 12

Author(s):

MIKE J.L. PETERS ◽

MARK M.J. NIELEN ◽

HENNIE G. RATERMAN ◽

ROBERT A. VERHEIJ ◽

FRANCOIS G. SCHELLEVIS ◽

...

Keyword(s):

Cardiovascular Disease ◽

Primary Care ◽

Inflammatory Arthritis ◽

Care Setting ◽

Primary Care Setting ◽

Conditional Logistic Regression ◽

Regression Analyses ◽

Cross Sectional ◽

Cardiovascular Risk Management ◽

And Control

Objective.To compare the prevalence of cardiovascular disease (CVD) in patients with inflammatory arthritis and control subjects registered in primary care.Methods.Conditional logistic regression analyses were used to compare the CVD prevalence in patients and controls, aged 50–75 years.Results.Overall, the CVD prevalence was 66.1 per 1000 patients in inflammatory arthritis and 37.3 per 1000 patients in controls, resulting in an odds ratio of 1.83 (95% confidence interval 1.33–2.51).Conclusion.Inflammatory arthritis patients registered in primary care are associated with an increased cardiovascular burden, which emphasizes the need for cardiovascular risk management in the primary care setting.

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The Importance of Family History in Breast Cancer Patients in Primary Care Setting: a Cross-sectional Study

Journal of Cancer Education ◽

10.1007/s13187-017-1237-0 ◽

2017 ◽

Vol 33 (3) ◽

pp. 602-609

Author(s):

Mehtap Kartal ◽

Nilgun Ozcakar ◽

Sehnaz Hatipoglu ◽

Makbule Neslisah Tan ◽

Azize Dilek Guldal

Keyword(s):

Breast Cancer ◽

Primary Care ◽

Family History ◽

Cancer Patients ◽

Care Setting ◽

Primary Care Setting ◽

Cross Sectional Study ◽

Breast Cancer Patients ◽

Sectional Study ◽

Cross Sectional

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Depression in Primary Care—More like Asthma Than Appendicitis: The Michigan Depression Project

The Canadian Journal of Psychiatry ◽

10.1177/070674379704200909 ◽

1997 ◽

Vol 42 (9) ◽

pp. 966-973 ◽

Cited By ~ 42

Author(s):

Michael S Klinkman ◽

Thomas L Schwenk ◽

James C Coyne

Keyword(s):

Social Support ◽

Primary Care ◽

Health Care ◽

Health Care Utilization ◽

Family Practice ◽

Care Setting ◽

Primary Care Setting ◽

Past History ◽

Care Utilization ◽

Primary Care Patients

Objective: To explore the relationships between detection, treatment, and outcome of depression in the primary care setting, based upon results from the Michigan Depression Project (MDP). Methods: A weighted sample of 425 adult family practice patients completed a comprehensive battery of questionnaires exploring stress, social support, overall health, health care utilization, treatment attitudes, self-rated levels of stress and depression, along with the Center for Epidemiologic Studies Depression Scale (CES-D), the Hamilton Rating Scale for Depression (HAM-D), and the Structured Clinical Interview for DSM-III (SCID), which served as the criterion standard for diagnosis. A comparison sample of 123 depressed psychiatric outpatients received the same assessment battery. Family practice patients received repeated assessment of depressive symptoms, stress, social support, and health care utilization over a period of up to 60 months of longitudinal follow-up. Results: The central MDP findings confirm that significant differences in past history, severity, and impairment exist between depressed psychiatric and family practice patients, that detection rates are significantly higher for severely depressed primary care patients, and that clinicians use clinical cues such as past history, distress, and severity of symptoms to “detect” depression in patients at intermediate and mild levels of severity. As well, there is a lack of association between detection and improved outcome in primary care patients. Conclusion: These results call into question the assumption that “depression is depression” irrespective of the setting and physician, and they are consistent with a model of depressive disorder as a subacute or chronic condition characterized by clinical parameters of severity, staging, and comorbidity, similar to asthma. This new model can guide further investigation into the epidemiology and management of mood disorders in the primary care setting.

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Association of Depression with Uncontrolled Hypertension in Primary Care Setting: A Cross-Sectional Study in Less-Developed Northwest China

International Journal of Hypertension ◽

10.1155/2021/6652228 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Lin Wang ◽

Nanfang Li ◽

Mulalibieke Heizhati ◽

Mei Li ◽

Zhikang Yang ◽

...

Keyword(s):

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Depression Scale ◽

Northwest China ◽

Directed Acyclic Graphs ◽

Uncontrolled Hypertension ◽

Lasso Regression ◽

Cross Sectional ◽

Optimal Adjustment

Background. Hypertensive patients commonly experience comorbid depression, which is closely associated with adverse health outcomes. This study aimed to examine the association between depression and uncontrolled hypertension in primary care setting of Northwest China. Methods. We used a stratified multistage random sampling method to obtain 1856 hypertensives subjects aged ≥18 years among primary care setting in Xinjiang, Northwest China, between April and October 2019. Depression was evaluated by Hospital Anxiety and Depression Scale (HADS), with a cut-off score ≥8. We related depression to uncontrolled hypertension, using multiple logistic regression, adjusting for minimally sufficient adjustment set of variables retrieved from a literature-based directed acyclic graphs (DAGs) and optimal adjustment set of variables derived from the least absolute shrinkage and selection operator (LASSO) regression. Results. A total of 1,653 (89.1%) patients had uncontrolled hypertension. The prevalence of depression was 14.5% and 7.4% among patients with uncontrolled and controlled hypertension. Depression was associated with 1.12-fold increased odds of uncontrolled hypertension [odds ratio (OR) 2.12, 95% confidence interval (CI): 1.23–3.65]. The association remained significant even after adjusting for the minimal sufficient adjustment sets and the optimal adjustment set of variables. Conclusion. Depression is significantly associated with uncontrolled hypertension in primary care setting of northwest China. The integrated management of depression and hypertension in the setting might be warranted.

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SEXUAL DYSFUNCTION AMONG WOMEN AT FOUR TO SIX MONTHS POSTPARTUM: A STUDY IN A PRIMARY CARE SETTING

Malaysian Journal of Public Health Medicine ◽

10.37268/mjphm/vol.20/no.1/art.569 ◽

2020 ◽

Vol 20 (1) ◽

pp. 235-243

Author(s):

Norafini Salamon ◽

Syahnaz Mohd Hashim ◽

Norfazilah Ahmad ◽

Suzaily Wahab

Keyword(s):

Primary Care ◽

Sexual Dysfunction ◽

Care Setting ◽

Primary Care Setting ◽

Cross Sectional Study ◽

Care Practice ◽

Cross Sectional ◽

Maternal Characteristics ◽

Local Setting ◽

Arousal Disorder

Sexual dysfunction in women is a significant health problem that harms marriage stability. Women in the Western countries were reportedly being affected by this condition after childbirth but the magnitude of the problem in our local setting is still unknown. The aim of this cross-sectional study was to determine the prevalence of women with sexual dysfunction at four to six months postpartum and its possible risk factors in an urban primary care setting. The participants were given a set of questionnaire, consisting of three parts; i) sociodemographic and maternal characteristics ii) Malay version of Female Sexual Function Index and iii) Malay DASS-21 questionnaire. Responses from 249 women were analyzed. More than half (57.0%,n=142) were found to have sexual dysfunction. The most prevalent types of sexual dysfunction reported by the affected women were sexual satisfaction disorder (98.6%), followed by arousal disorder (58.5%) and lubrication disorder (28.9%). Three factors were found to be significantly associated with sexual dysfunction; household income of less than RM2000 (adj OR = 0.31, 95% CI 0.14, 0.70), Malay ethnic group (adj OR = 1.93,95% CI 1.02, 3.66) and breastfeeding (adj OR = 2.24,95% CI 1.03, 4.85). In conclusion, the prevalence of sexual dysfunction in the postpartum period was considerably high. Efforts should be made to incorporate sexual health as part of the routine postnatal assessment in primary care practice.

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