{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:16:11Z","timestamp":1793380571356,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["447636"],"award-info":[{"award-number":["447636"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>By mid-July 2020, more than 108,000 COVID-19 cases had been diagnosed in Canada with more than half in the province of Quebec. In this context, we launched a study to analyze the epidemiological characteristics and the socio-economic impact of the spring outbreak in the population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted an online survey of the participants of the CARTaGENE population-based cohort, composed of middle-aged and older adults. We collected information on socio-demographic, lifestyle, health condition, COVID-19 related symptoms and COVID-19 testing. We studied the association between these factors and two outcomes: the status of having been tested for SARS-CoV-2 and the status of having received a positive test. These associations were measured with univariate and multivariate analyses using a hybrid tree-based regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 8,129 respondents from the CARTaGENE cohort, 649 were tested for COVID-19 and 41 were positive. Medical workers and individuals having a contact with a COVID-19 patient had the highest probabilities of being tested (32% and 42.4%, respectively) and of being positive (17.2% and 13.0%, respectively) among those tested. Approximately 8% of the participants declared that they have experienced at least one of the four COVID-19 related symptoms chosen by the Public Health authorities (fever, cough, dyspnea, anosmia) but were not tested. Results from the tree-based model analyses adjusted on exposure factors showed that the combination of dyspnea, dry cough and fever was highly associated with being tested whereas anosmia, fever, and headache were the most discriminant factors for having a positive test among those tested. During the spring outbreak, more than one third of the participants have experienced a decrease in access to health services. There were gender and age differences in the socio-economic and emotional impacts of the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We have shown some discrepancies between the symptoms associated with being tested and being positive. In particular, the anosmia is a major discriminant symptom for positivity whereas ear-nose-throat symptoms seem not to be COVID-19 related. The results also emphasize the need of increasing the accessibility of testing for the general population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-021-06002-0","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T04:03:56Z","timestamp":1620619436000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiological characteristics of the COVID-19 spring outbreak in Quebec, Canada: a population-based study"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1356-238X","authenticated-orcid":false,"given":"Rodolphe","family":"Jantzen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nolwenn","family":"Noisel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Camilleri-Bro\u00ebt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Labb\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault de","family":"Malliard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Payette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Bro\u00ebt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,10]]},"reference":[{"key":"6002_CR1","unstructured":"Situation of the Coronavirus (COVID-19) in Qu\u00e9bec. 2020. https:\/\/www.quebec.ca\/en\/health\/health-issues\/a-z\/2019-coronavirus\/situation-coronavirus-in-quebec\/. Accessed 5 Aug 2020."},{"key":"6002_CR2","unstructured":"Public Health Agency of Canada. 2020. https:\/\/www.canada.ca\/en\/public-health.html. Accessed 5 Aug 2020."},{"issue":"20","key":"6002_CR3","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1001\/jama.2020.6775","volume":"323","author":"S Richardson","year":"2020","unstructured":"Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, and the Northwell COVID-19 Research Consortium, Barnaby DP, Becker LB, Chelico JD, Cohen SL, Cookingham J, Coppa K, Diefenbach MA, Dominello AJ, Duer-Hefele J, Falzon L, Gitlin J, Hajizadeh N, Harvin TG, Hirschwerk DA, Kim EJ, Kozel ZM, Marrast LM, Mogavero JN, Osorio GA, Qiu M, Zanos TP. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020; 323(20):2052. https:\/\/doi.org\/10.1001\/jama.2020.6775.","journal-title":"JAMA"},{"key":"6002_CR4","doi-asserted-by":"publisher","unstructured":"Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, Holden KA, Read JM, Dondelinger F, Carson G, Merson L, Lee J, Plotkin D, Sigfrid L, Halpin S, Jackson C, Gamble C, Horby PW, Nguyen-Van-Tam JS, Ho A, Russell CD, Dunning J, Openshaw PJ, Baillie JK, Semple MG. Features of 20 133 UK patients in hospital with Covid-19 using the ISARIC WHO Clinical Characterisation Protocol: Prospective observational cohort study. BMJ. 2020:m1985. https:\/\/doi.org\/10.1136\/bmj.m1985.","DOI":"10.1136\/bmj.m1985"},{"issue":"10229","key":"6002_CR5","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","volume":"395","author":"F Zhou","year":"2020","unstructured":"Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. The Lancet. 2020; 395(10229):1054\u201362. https:\/\/doi.org\/10.1016\/S0140-6736(20)30566-3.","journal-title":"The Lancet"},{"issue":"1","key":"6002_CR6","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1186\/s12916-020-01665-z","volume":"18","author":"SE Brill","year":"2020","unstructured":"Brill SE, Jarvis HC, Ozcan E, Burns TLP, Warraich RA, Amani LJ, Jaffer A, Paget S, Sivaramakrishnan A, Creer DD. COVID-19: A retrospective cohort study with focus on the over-80s and hospital-onset disease. BMC Med. 2020; 18(1):194. https:\/\/doi.org\/10.1186\/s12916-020-01665-z.","journal-title":"BMC Med"},{"issue":"1","key":"6002_CR7","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1186\/s12916-020-01640-8","volume":"18","author":"CL Niedzwiedz","year":"2020","unstructured":"Niedzwiedz CL, O\u2019Donnell CA, Jani BD, Demou E, Ho FK, Celis-Morales C, Nicholl BI, Mair FS, Welsh P, Sattar N, Pell JP, Katikireddi SV. Ethnic and socioeconomic differences in SARS-CoV-2 infection: Prospective cohort study using UK Biobank. BMC Med. 2020; 18(1):160. https:\/\/doi.org\/10.1186\/s12916-020-01640-8.","journal-title":"BMC Med"},{"issue":"10247","key":"6002_CR8","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/S0140-6736(20)31304-0","volume":"396","author":"S Stringhini","year":"2020","unstructured":"Stringhini S, Wisniak A, Piumatti G, Azman AS, Lauer SA, Baysson H, De Ridder D, Petrovic D, Schrempft S, Marcus K, Yerly S, Arm Vernez I, Keiser O, Hurst S, Posfay-Barbe KM, Trono D, Pittet D, G\u00e9taz L, Chappuis F, Eckerle I, Vuilleumier N, Meyer B, Flahault A, Kaiser L, Guessous I. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): A population-based study. The Lancet. 2020; 396(10247):313\u20139. https:\/\/doi.org\/10.1016\/S0140-6736(20)31304-0.","journal-title":"The Lancet"},{"key":"6002_CR9","doi-asserted-by":"publisher","unstructured":"Menni C, Valdes AM, Freidin MB, Sudre CH, Nguyen LH, Drew DA, Ganesh S, Varsavsky T, Cardoso MJ, El-Sayed Moustafa JS, Visconti A, Hysi P, Bowyer RCE, Mangino M, Falchi M, Wolf J, Ourselin S, Chan AT, Steves CJ, Spector TD. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med. 2020. https:\/\/doi.org\/10.1038\/s41591-020-0916-2.","DOI":"10.1038\/s41591-020-0916-2"},{"issue":"5","key":"6002_CR10","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1093\/ije\/dys160","volume":"42","author":"P Awadalla","year":"2013","unstructured":"Awadalla P, Boileau C, Payette Y, Idaghdour Y, Goulet J-P, Knoppers B, Hamet P, Laberge C. Cohort profile of the CARTaGENE study: Quebec\u2019s population-based biobank for public health and personalized genomics. Int J Epidemiol. 2013; 42(5):1285\u201399. https:\/\/doi.org\/10\/f5hh87.","journal-title":"Int J Epidemiol"},{"key":"6002_CR11","unstructured":"RAMQ. Table PA.01 - Nombre de Personnes Inscrites et Admissibles Au R\u00e9gime d\u2019assurance Maladie Du Qu\u00e9bec Selon Le Sexe, Le Groupe d\u2019\u00e2ge et La R\u00e9gion Sociosanitaire. 2017. https:\/\/www4.prod.ramq.gouv.qc.ca\/IST\/CD\/CDF_DifsnInfoStats\/CDF1_CnsulInfoStatsCNC_iut\/DifsnInfoStats.aspx?ETAPE_COUR=3&IdPatronRapp=8&Annee=2017&Per=0&LANGUE=en-CA. Accessed 25 Nov 2019."},{"issue":"23","key":"6002_CR12","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1503\/cmaj.170292","volume":"190","author":"TJB Dummer","year":"2018","unstructured":"Dummer TJB, Awadalla P, Boileau C, Craig C, Fortier I, Goel V, Hicks JMT, Jacquemont S, Knoppers BM, Le N, McDonald T, McLaughlin J, Mes-Masson A-M, Nuyt A-M, Palmer LJ, Parker L, Purdue M, Robson PJ, Spinelli JJ, Thompson D, Vena J, Zawati M. The Canadian Partnership for Tomorrow Project: A pan-Canadian platform for research on chronic disease prevention. CMAJ Can Med Assoc J. 2018; 190(23):710\u20137. https:\/\/doi.org\/10\/gdqs3d.","journal-title":"CMAJ Can Med Assoc J"},{"key":"6002_CR13","unstructured":"CARTaGENE. Questionnaire Study on Coronavirus and Covid-19. 2020. https:\/\/www.cartagene.qc.ca\/sites\/default\/files\/documents\/survey\/CAG%20COVID-19%20Qx_2020-05-25_EN_CER.pdf. Accessed 5 Aug 2020."},{"key":"6002_CR14","unstructured":"MSSS. D\u00e9finition de Cas de COVID-19 - Qu\u00e9bec. 2020. https:\/\/msss.gouv.qc.ca\/professionnels\/documents\/coronavirus-2019-ncov\/definition-nosologique-COVID-19-020-04-08.pdf. Accessed 5 Aug 2020."},{"issue":"1","key":"6002_CR15","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","volume":"57","author":"Y Benjamini","year":"1995","unstructured":"Benjamini Y, Hochberg Y. Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. J R Stat Soc Ser B (Methodol). 1995; 57(1):289\u2013300.","journal-title":"J R Stat Soc Ser B (Methodol)"},{"issue":"1","key":"6002_CR16","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/2043-9113-4-6","volume":"4","author":"C Mbogning","year":"2014","unstructured":"Mbogning C, Perdry H, Toussile W, Bro\u00ebt P. A novel tree-based procedure for deciphering the genomic spectrum of clinical disease entities. J Clin Bioinforma. 2014; 4(1):6. https:\/\/doi.org\/10.1186\/2043-9113-4-6.","journal-title":"J Clin Bioinforma"},{"issue":"3\/4","key":"6002_CR17","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1159\/000380850","volume":"79","author":"C Mbogning","year":"2015","unstructured":"Mbogning C, Perdry H, Bro\u00ebt P. A Bagged, Partially Linear, Tree-Based Regression Procedure for Prediction and Variable Selection. Hum Hered. 2015; 79(3\/4):182\u201393.","journal-title":"Hum Hered"},{"key":"6002_CR18","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2020","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing; 2020."},{"key":"6002_CR19","unstructured":"INSPQ. Donn\u00e9es COVID-19 au Qu\u00e9bec. 2020. https:\/\/www.inspq.qc.ca\/covid-19\/donnees. Accessed 5 Aug 2020."},{"key":"6002_CR20","doi-asserted-by":"publisher","unstructured":"Kaur G, Mohan A, Mohan E, Aprajita N, Mohan M. A Review of the Importance of Atypical Otorhinolaryngological Symptoms in the Screening of COVID-19 Patients. Indian J Otolaryngol Head Neck Surg Off Publ Assoc Otolaryngologists India. 2020:1\u20135. https:\/\/doi.org\/10.1007\/s12070-020-02045-y.","DOI":"10.1007\/s12070-020-02045-y"},{"issue":"3","key":"6002_CR21","doi-asserted-by":"publisher","first-page":"21866","DOI":"10.2196\/21866","volume":"6","author":"F Adorni","year":"2020","unstructured":"Adorni F, Prinelli F, Bianchi F, Giacomelli A, Pagani G, Bernacchia D, Rusconi S, Maggi S, Trevisan C, Noale M, Molinaro S, Bastiani L, Fortunato L, Jesuthasan N, Sojic A, Pettenati C, Tavio M, Andreoni M, Mastroianni C, Antonelli Incalzi R, Galli M. Self-Reported Symptoms of SARS-CoV-2 Infection in a Nonhospitalized Population in Italy: Cross-Sectional Study of the EPICOVID19 Web-Based Survey. JMIR Public Health Surveill. 2020; 6(3):21866. https:\/\/doi.org\/10.2196\/21866.","journal-title":"JMIR Public Health Surveill"},{"key":"6002_CR22","doi-asserted-by":"publisher","unstructured":"Dixon BE, Wools-Kaloustian K, Fadel WF, Duszynski TJ, Yiannoutsos C, Halverson PK, Menachemi N. Symptoms and symptom clusters associated with SARS-CoV-2 infection in community-based populations: Results from a statewide epidemiological study. medRxiv. 2020. https:\/\/doi.org\/10.1101\/2020.10.11.20210922.","DOI":"10.1101\/2020.10.11.20210922"},{"key":"6002_CR23","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jad.2020.08.001","volume":"277","author":"J Xiong","year":"2020","unstructured":"Xiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L, Chen-Li D, Iacobucci M, Ho R, Majeed A, McIntyre RS. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders. 2020; 277:55\u201364. https:\/\/doi.org\/10.1016\/j.jad.2020.08.001.","journal-title":"Journal of Affective Disorders"},{"key":"6002_CR24","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.sleep.2020.07.009","volume":"74","author":"BY-M Yu","year":"2020","unstructured":"Yu BY-M, Yeung W-F, Lam JC-S, Yuen SC-S, Lam SC, Chung VC-H, Chung K-F, Lee PH, Ho FY-Y, Ho JY-S. Prevalence of sleep disturbances during COVID-19 outbreak in an urban Chinese population: A cross-sectional study. Sleep Med. 2020; 74:18\u201324. https:\/\/doi.org\/10.1016\/j.sleep.2020.07.009.","journal-title":"Sleep Med"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06002-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06002-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06002-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T09:57:11Z","timestamp":1725011831000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06002-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,10]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6002"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06002-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.08.26.20182675","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,10]]},"assertion":[{"value":"12 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This project has been approved by the Research Ethics Board of the Sainte-Justine University Hospital Centre (number FWA00021692) on 28th May 2020 under the reference MP-21-2011-345, 3297. CARTaGENE access committee evaluated the project and approved the usage of the raw data. A standard access agreement was also signed by the researchers and the Director of research of the Sainte-Justine hospital. The approved protocol is available on https:\/\/osf.io\/2mjfe\/. All participants have given written consent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"435"}}