COVID-Q: validation of the first COVID-19 questionnaire based on patient-rated symptom gravity (preprint)

ABSTRACT

Objectives The aim of the present study was to develop and validate the CoronaVirus Disease 2019 (COVID19) Questionnaire (COVIDQ), a novel symptom questionnaire specific for COVID19 patients, to provide a comprehensive evaluation which may be helpful for physicians. A secondary goal of the present study was to evaluate the performance of the COVIDQ in identifying subjects at higher risk of being tested positive for COVID19. Material and methods Consecutive not hospitalized adults who underwent nasopharyngeal and throat swab for severe acute respiratory syndrome coronavirus 2 (SARSCoV2) detection at Treviso Hospital in March 2020, were enrolled. Subjects were divided into positive (cases) and negative (controls) in equal number. All of them gave consent and answered the COVIDQ. Patients not able to answer the COVIDQ due to clinical conditions were excluded. Parallel Analysis and Principal Component Analysis were used to identify clusters of items measuring the same dimension. The Item Response Theory (IRT) based analyses evaluated the functioning of item categories, the presence of clusters of local dependence among items, item fit within the model and model fit to the data. Results Answers obtained from 230 COVID19 cases (113 males, and 117 females; mean age 55 years, range 20 to 99 years) and 230 controls (61 males, and 169 females; mean age 46 years, range 21 to 89) were analyzed. Parallel analysis led to the extraction of six components, which corresponded to as many clinical presentation patterns asthenia, influenza symptoms, ear and nose symptoms, breathing issues, throat symptoms, and anosmia/ageusia. The final IRT models retained 27 items as significant for symptom assessment. The total score on the questionnaire was significantly associated with positivity to the molecular SARSCoV2 test subjects with multiple symptoms were significantly more likely to be affected by COVID19 (p < .001). Older age and male gender also represented risk factors. Presence of breathing issues and anosmia/ageusia were significantly related to positivity to SARSCoV2 (p < 0.001). None of the examined comorbidities had a significant association with COVID19 diagnosis. Conclusion According to the analyses, COVIDQ could be validated since the aspects it evaluated were overall significantly related to SARSCoV2 infection. The application of the novel COVIDQ to everyday clinical practice may help identifying subjects who are likely to be affected by COVID19 and address them to a nasopharyngeal swab in order to achieve an early diagnosis.