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Patterns of repeated diagnostic testing for COVID-19 in relation to patient characteristics and outcomes.
Salerno, S; Zhao, Z; Prabhu Sankar, S; Salvatore, M; Gu, T; Fritsche, L G; Lee, S; Lisabeth, L D; Valley, T S; Mukherjee, B.
  • Salerno S; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
  • Zhao Z; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
  • Prabhu Sankar S; Rogel Cancer Center, University of Michigan Medicine, Ann Arbor, MI, USA.
  • Salvatore M; Data Office for Clinical and Translational Research, University of Michigan, Ann Arbor, MI, USA.
  • Gu T; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
  • Fritsche LG; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
  • Lee S; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
  • Lisabeth LD; Rogel Cancer Center, University of Michigan Medicine, Ann Arbor, MI, USA.
  • Valley TS; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
  • Mukherjee B; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
J Intern Med ; 289(5): 726-737, 2021 05.
Article in English | MEDLINE | ID: covidwho-991594
ABSTRACT

BACKGROUND:

Whilst the COVID-19 diagnostic test has a high false-negative rate, not everyone initially negative is re-tested. Michigan Medicine, a primary regional centre, provided an ideal setting for studying testing patterns during the first wave of the pandemic.

OBJECTIVES:

To identify the characteristics of patients who underwent repeated testing for COVID-19 and determine if repeated testing was associated with downstream outcomes amongst positive cases.

METHODS:

Characteristics, test results, and health outcomes for patients presenting for a COVID-19 diagnostic test were collected. We examined whether patient characteristics differed with repeated testing and estimated a false-negative rate for the test. We then studied repeated testing patterns in patients with severe COVID-19-related outcomes.

RESULTS:

Patient age, sex, body mass index, neighbourhood poverty levels, pre-existing type 2 diabetes, circulatory, kidney, and liver diseases, and cough, fever/chills, and pain symptoms 14 days prior to a first test were associated with repeated testing. Amongst patients with a positive result, age (OR 1.17; 95% CI (1.05, 1.34)) and pre-existing kidney diseases (OR 2.26; 95% CI (1.41, 3.68)) remained significant. Hospitalization (OR 7.88; 95% CI (5.15, 12.26)) and ICU-level care (OR 6.93; 95% CI (4.44, 10.92)) were associated with repeated testing. The estimated false-negative rate was 23.8% (95% CI (19.5%, 28.5%)).

CONCLUSIONS:

Whilst most patients were tested once and received a negative result, a meaningful subset underwent multiple rounds of testing. These results shed light on testing patterns and have important implications for understanding the variation of repeated testing results within and between patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: False Negative Reactions / COVID-19 Nucleic Acid Testing / SARS-CoV-2 / COVID-19 / Intensive Care Units Type of study: Diagnostic study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Intern Med Journal subject: Internal Medicine Year: 2021 Document Type: Article Affiliation country: Joim.13213

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Full text: Available Collection: International databases Database: MEDLINE Main subject: False Negative Reactions / COVID-19 Nucleic Acid Testing / SARS-CoV-2 / COVID-19 / Intensive Care Units Type of study: Diagnostic study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Intern Med Journal subject: Internal Medicine Year: 2021 Document Type: Article Affiliation country: Joim.13213