{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:19:06Z","timestamp":1790666346651,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Symptom criteria for COVID\u201019 testing of heath care workers (HCWs) limitations on testing availability have been challenging during the COVID\u201019 pandemic. An evidence\u2010based symptom criteria for identifying HCWs for testing, based on the probability of positive COVID\u201019 test results, would allow for a more appropriate use of testing resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an observational study of outpatient COVID\u201019 testing of HCWs. Prior to testing, HCWs were asked about the presence of 10 symptoms. Their responses were then compared to their subsequent pharyngeal swab COVID\u201019 polymerase chain reaction test results. These data were used to derive and evaluate a symptom\u2010based testing criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 961 HCWs were included in the analysis, of whom 225 (23%) had positive test results. Loss of taste or smell was the symptom with the largest positive likelihood ratio (3.33). Dry cough, regardless of the presence or absence of other symptoms, was the most sensitive (74%) and the least specific (32%) symptom. The existing testing criteria consisting of any combination of one or more of three symptoms (fever, shortness of breath, dry cough) was 93% sensitive and 9% specific (area unce the curve [AUC]\u00a0=\u00a00.63, 95% confidence interval [CI]\u00a0=\u00a00.59 to 0.67). The derived testing criteria consisting of any combination of one or more of two symptoms (fever, loss of taste or smell) was 89% sensitive and 48% specific (AUC\u00a0=\u00a00.75, 95% CI\u00a0=\u00a00.71 to 0.78). The hybrid testing criteria consisting of any combination of one or more of four symptoms (fever, shortness of breath, dry cough, loss of taste or smell) was 98% sensitive and 8% specific (AUC\u00a0=\u00a00.77, 95% CI\u00a0=\u00a00.73 to 0.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An evidence\u2010based approach to COVID\u201019 testing that at least includes fever and loss of taste or smell should be utilized when determining which HCWs should be tested.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14009","type":"journal-article","created":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T20:35:36Z","timestamp":1589315736000},"page":"469-474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Symptom Criteria for COVID\u201019 Testing of Heath Care Workers"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7610-3087","authenticated-orcid":false,"given":"Brian M.","family":"Clemency","sequence":"first","affiliation":[{"name":"From Department of Emergency Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renoj","family":"Varughese","sequence":"additional","affiliation":[{"name":"From Department of Emergency Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle K.","family":"Scheafer","sequence":"additional","affiliation":[{"name":"From Department of Emergency Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Ludwig","sequence":"additional","affiliation":[{"name":"From Department of Emergency Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob V.","family":"Welch","sequence":"additional","affiliation":[{"name":"From Department of Emergency Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"McCormack","sequence":"additional","affiliation":[{"name":"From Department of Emergency Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changxing","family":"Ma","sequence":"additional","affiliation":[{"name":"the Department of Biostatistics University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Nan","sequence":"additional","affiliation":[{"name":"the Department of Biostatistics University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Giambra","sequence":"additional","affiliation":[{"name":"and Department of Medicine Catholic Health System Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Raab","sequence":"additional","affiliation":[{"name":"and Department of Medicine Catholic Health System Buffalo NY USA"},{"name":"and Department of Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30627-9"},{"key":"e_1_2_6_3_1","unstructured":"Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019\u2010nCoV) in Wuhan China. 2020. 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