Can we use temperature measurements to identify pre-symptomatic SARS-CoV-2 infection in nursing home residents?
J Am Geriatr Soc
; 70(11): 3239-3244, 2022 11.
Article
in English
| MEDLINE | ID: covidwho-1968150
ABSTRACT
BACKGROUND:
COVID-19 has had a severe impact on morbidity and mortality among nursing home (NH) residents. Earlier detection of SARS-CoV-2 may position us to better mitigate the risk of spread. Both asymptomatic and pre-symptomatic transmission are common in outbreaks, and threshold temperatures, such as 38C, for screening for infection could miss timely detection in the majority of residents. We hypothesized that in long-term care residents, temperature trends with SARS-CoV-2 infection could identify infection in pre-symptomatic individuals earlier than standard screening.METHODS:
We conducted a retrospective cohort study using electronic health records in 6176 residents of the VA NHs who underwent SARS-CoV-2 testing triggered by symptoms. We collected information about age and other demographics, baseline temperature, and specific comorbidities. We created standardized definitions, and a hypothetical model to test measures of temperature variation and compare outcomes to the VA standard of care.RESULTS:
We showed that a change from baseline of 0.4C identified 47% of NH residents who became SARS-CoV-2 positive, earlier than standard testing by an average of 42.2 h. Temperature variability of 0.5C over 3 days when paired with a 37.2C temperature cutoff identified 55% of NH residents who became SARS-CoV-2 positive earlier than the standard of care testing by an average of 44.4 h. A change from baseline temperature of 0.4C when combined with temperature variability of 0.7C over 3 days identified 52% of NH residents who became SARS-CoV-2 positive, earlier than standard testing by an average of 40 h, and by more than 3 days in 22% of the residents. This earlier detection comes at the expense of triggering 57,793 tests, as compared to the number of trigger tests ordered in the VA system of 40,691.CONCLUSIONS:
Our model suggests that early temperature trends with SARS-CoV-2 infection may identify infection in pre-symptomatic long-term care residents.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
J Am Geriatr Soc
Year:
2022
Document Type:
Article
Affiliation country:
Jgs.17972
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