Epidemiological and clinical characteristics of SARS-CoV-2 infections at a testing site in Berlin, Germany, March and April 2020—a cross-sectional study. (December 2020)

• Record Type: Journal Article
• Authors: Maechler, Friederike; Gertler, Maximilian; Hermes, Julia; van Loon, Welmoed; Schwab, Frank; Piening, Brar; Rojansky, Shay; Hommes, Franziska; Kausch, Franka; Lindner, Andreas K.; Burock, Susen; Rössig, Heike; Hartmann, Claudia; Kirchberger, Valerie; Thieme, Alexander; Behnke, Michael; Gastmeier, Petra; Mockenhaupt, Frank P.; Seybold, Joachim
• Is Part Of: Clinical microbiology and infection. Volume 26:Number 12(2020)
• Page Start: 1685.e7
• Page End: 1685.e12
• Publication Date: 2020-12
• Subjects: Asymptomatic -- Coronavirus -- Coronavirus disease 2019 -- Olfaction disorders -- Screening -- Severe acute respiratory syndrome coronavirus 2; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2020.08.017
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Objective: In Berlin, the first public severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing site started 1 day after the first case in the city occurred. We describe epidemiological and clinical characteristics and aim at identifying risk factors for SARS-CoV-2 detection during the first 6 weeks of operation. Methods: Testing followed national recommendations, but was also based on the physician's discretion. We related patient characteristics to SARS-CoV-2 test positivity for exploratory analyses using a cross-sectional, observational study design. Results: Between 3 March and 13 April 2020, 5179 individuals attended the site (median age 34 years; interquartile range 26–47 years). The median time since disease onset was 4 days (interquartile range 2–7 days). Among 4333 persons tested, 333 (7.7%) were positive. Test positivity increased up to 10.3% (96/929) during the first 3 weeks and then declined, paralleling Germany's lock-down and the course of the epidemic in Berlin. Strict adherence to testing guidelines resulted in 10.4% (262/2530) test positivity, compared with 3.9% (71/1803) among individuals tested for other indications. A nightclub was a transmission hotspot; 27.7% (26/94) of one night's visitors were found positive. Smell and/or taste dysfunction indicated coronavirus disease 2019 (COVID-19) with 85.6% specificity (95% CI 82.1%–88.1%). Four per cent (14/333) of those infected were asymptomatic. Risk factors for detection of SARS-CoV-2 infection were recent contact with a positive case (second week after contact, OR 3.42; 95% CI 2.48–4.71), travel to regions of high pandemic activity (e.g. Austria, OR 4.16; 95% CI 2.48–6.99), recent onset of symptoms (second week, OR 3.61; 95% CI 1.87–6.98) and an impaired sense of smell/taste (4.08; 95% CI 2.36–7.03). Conclusions: In this young population, early-onset presentation of COVID-19 resembled flu-like symptoms, except for smell and/or taste dysfunction. Risk factors for SARS-CoV-2 detection were return from regions with high incidence and contact with confirmed SARS-CoV-2 cases, particularly when tests were administered within the first 2 weeks after contact and/or onset of symptoms.