{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:09:21Z","timestamp":1758672561448,"version":"3.44.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Johann Wolfgang Goethe-Universit\u00e4t, Frankfurt am Main"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Establishing a strong correlation between active SARS-CoV-2 infection and COVID-19 severity could enhance early risk assessment, predict disease outcomes, and identify patients needing urgent treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this prospective SARS-CoV-2 transmission cohort study, we introduce the potential of a symptoms severity score (S3) based on patient self-reported symptoms and further evaluate its utility for predicting SARS-CoV-2 infection status and viral load. The S3 construct, derived from a participant survey using pre-defined scales (Cronbach\u2019s alpha=0.7), was categorized as asymptomatic, mild to moderate, or severe. This analysis comprised nine household contacts, contributing 1,410 qualitative and 89 quantitative visit\u2011test observations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>S3 showed a high correlation with total symptoms (Pearson <jats:italic>r<\/jats:italic>\u2009=\u20090.963, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The categorized version (S3C) also correlated strongly with the number of symptoms (Spearman\u2019s <jats:italic>r<\/jats:italic>\u2009=\u20090.988, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). A generalized estimating equation (GEE) model revealed that participants with severe symptoms had 6.5 times higher odds of having an active SARS-CoV-2 infection than those with no symptoms (Odds Ratio\u2009=\u20096.5, 95% CI: 3.5 to 12.4, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Similar significant results were found for severe vs. mild to moderate symptoms (OR\u2009=\u20092.3, CI: 1.3 to 4.1, <jats:italic>p<\/jats:italic>\u2009=\u20090.0025) and mild to moderate vs. asymptomatic (OR\u2009=\u20092.8, 95% CI: 1.4 to 5.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.0030).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Our findings demonstrate that self-reported symptom severity and number of symptoms are robust predictors of SARS-CoV-2 infection and viral load, providing potential utility in clinical risk stratification. However, limitations, including a small sample size for viral load analyses and reliance on self-reported data, should be considered.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12879-025-11653-4","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T07:22:31Z","timestamp":1758612151000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A composite symptoms severity score based on survey self-reports as a predictor of SARS-CoV-2 infection and viral load"],"prefix":"10.1186","volume":"25","author":[{"given":"Damian","family":"Diaz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse A.","family":"Canchola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana M.","family":"Groh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuna","family":"Toptan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Jarem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison L.","family":"Kuchta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscilla","family":"Moonsamy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemarie","family":"Berger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria J. 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Ana M. Groh, Damian Diaz, Tuna Toptan, and Sandra Ciesek have no conflicts of interest to disclose. Jesse A. Canchola, Daniel Jarem, and Alison Kuchta are employees of Roche Molecular Systems and hold shar in F Hoffman-La Roche. Priscilla Moonsamy is an employee of Roche Molecular Systems. Maria J.G.T. Vehreschild has received grants from Heel, MSD, Roche and Tillotts; consulting fees from Bactolife, Bioaster, Ecraid, Eumedica, Gilead, GSK, Pfizer and Tillotts; and honoraria from Akademie f\u00fcr Infektionsmedizin, AstraZeneca, bioMerieux, Biotest, DGI, European Society of Neurogastroenterology, Falk Foundation, FomF GmbH, Gilead, GSK, Helios Kliniken, Hessisches Landessozialgericht, Infektio Forum, Janssen Cilag GmbH, Klinikum Kasseln, Landes\u00e4rztekammer Hessen, LMU Kliniken, MSD, Pfizer, Streamed up, St. Vincent Hospital and Tillotts.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1116"}}