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Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study.
Eythorsson, Elias; Helgason, Dadi; Ingvarsson, Ragnar Freyr; Bjornsson, Helgi K; Olafsdottir, Lovisa Bjork; Bjarnadottir, Valgerdur; Runolfsdottir, Hrafnhildur Linnet; Bjarnadottir, Solveig; Agustsson, Arnar Snaer; Oskarsdottir, Kristin; Thorvaldsson, Hrafn Hliddal; Kristjansdottir, Gudrun; Armannsdottir, Brynja; Bjarnason, Agnar; Johannsson, Birgir; Gudlaugsson, Olafur; Gottfredsson, Magnus; Sigurdsson, Martin I; Indridason, Olafur S; Palsson, Runolfur.
  • Eythorsson E; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Helgason D; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Ingvarsson RF; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Bjornsson HK; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Olafsdottir LB; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Bjarnadottir V; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Runolfsdottir HL; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Bjarnadottir S; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Agustsson AS; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
  • Oskarsdottir K; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Thorvaldsson HH; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Kristjansdottir G; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Armannsdottir B; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Bjarnason A; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
  • Johannsson B; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Gudlaugsson O; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Gottfredsson M; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
  • Sigurdsson MI; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Indridason OS; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
  • Palsson R; Landspitali-National University Hospital of Iceland, Hringbraut 101, 101 Reykjavík, Iceland.
BMJ ; 371: m4529, 2020 12 02.
Article in English | MEDLINE | ID: covidwho-955486
ABSTRACT

OBJECTIVE:

To characterise the symptoms of coronavirus disease 2019 (covid-19).

DESIGN:

Population based cohort study.

SETTING:

Iceland.

PARTICIPANTS:

All individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) between 17 March and 30 April 2020. Cases were identified by three testing strategies targeted testing guided by clinical suspicion, open invitation population screening based on self referral, and random population screening. All identified cases were enrolled in a telehealth monitoring service, and symptoms were systematically monitored from diagnosis to recovery. MAIN OUTCOME

MEASURES:

Occurrence of one or more of 19 predefined symptoms during follow-up.

RESULTS:

Among 1564 people positive for SARS-CoV-2, the most common presenting symptoms were myalgia (55%), headache (51%), and non-productive cough (49%). At the time of diagnosis, 83 (5.3%) individuals reported no symptoms, of whom 49 (59%) remained asymptomatic during follow-up. At diagnosis, 216 (14%) and 349 (22%) people did not meet the case definition of the Centers for Disease Control and Prevention and the World Health Organization, respectively. Most (67%) of the SARS-CoV-2-positive patients had mild symptoms throughout the course of their disease.

CONCLUSION:

In the setting of broad access to RT-PCR testing, most SARS-CoV-2-positive people were found to have mild symptoms. Fever and dyspnoea were less common than previously reported. A substantial proportion of SARS-CoV-2-positive people did not meet recommended case definitions at the time of diagnosis.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMJ Journal subject: Medicine Year: 2020 Document Type: Article Affiliation country: Bmj.m4529

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMJ Journal subject: Medicine Year: 2020 Document Type: Article Affiliation country: Bmj.m4529