{"doi":"10.1093/cid/ciac112","title":"Predictive Value of Isolated Symptoms for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children Tested During Peak Circulation of the Delta Variant","abstract":"BACKGROUND: Coronavirus disease 2019 (COVID-19) testing policies for symptomatic children attending US schools or daycare vary, and whether isolated symptoms should prompt testing is unclear. We evaluated children presenting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing to determine if the likelihood of having a positive SARS-CoV-2 test differed between participants with 1 symptom vs ≥2 symptoms, and to examine the predictive capability of isolated symptoms. METHODS: Participants aged <18 years presenting for clinical SARS-CoV-2 molecular testing in 6 sites in urban/suburban/rural Georgia (July-October, 2021; Delta variant predominant) were queried about individual symptoms. Participants were classified into 3 groups: asymptomatic, 1 symptom only, or ≥2 symptoms. SARS-CoV-2 test results and clinical characteristics of the 3 groups were compared. Sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) for isolated symptoms were calculated by fitting a saturated Poisson model. RESULTS: Of 602 participants, 21.8% tested positive and 48.7% had a known or suspected close contact. Children reporting 1 symptom (n = 82; odds ratio [OR], 6.00 [95% confidence interval {CI}, 2.70-13.33]) and children reporting ≥2 symptoms (n = 365; OR, 5.25 [95% CI, 2.66-10.38]) were significantly more likely to have a positive COVID-19 test than asymptomatic children (n = 155), but they were not significantly different from each other (OR, 0.88 [95% CI, .52-1.49]). Sensitivity and PPV were highest for isolated fever (33% and 57%, respectively), cough (25% and 32%), and sore throat (21% and 45%); headache had low sensitivity (8%) but higher PPV (33%). Sensitivity and PPV of isolated congestion/rhinorrhea were 8% and 9%, respectively. CONCLUSIONS: With high Delta variant prevalence, children with isolated symptoms were as likely as those with multiple symptoms to test positive for COVID-19. Isolated fever, cough, sore throat, or headache, but not congestion/rhinorrhea, offered the highest predictive value.","journal":"Clinical Infectious Diseases","year":2022,"id":289211,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9605,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":970847,"name":"Laura Benedit","orcid":null,"position":1,"is_corresponding":false},{"id":377303,"name":"Jennifer K. Frediani","orcid":"0000-0002-4634-0591","position":2,"is_corresponding":false},{"id":454883,"name":"Mark Griffiths","orcid":"0000-0001-8612-1783","position":3,"is_corresponding":false},{"id":970848,"name":"Nabeel Yar Khan","orcid":null,"position":4,"is_corresponding":false},{"id":336427,"name":"Joshua M. Levy","orcid":"0000-0001-5907-3421","position":5,"is_corresponding":false},{"id":333554,"name":"Claudia R. Morris","orcid":"0000-0001-6019-2858","position":6,"is_corresponding":false},{"id":94488,"name":"Christina A. Rostad","orcid":"0000-0001-8439-0592","position":7,"is_corresponding":false},{"id":500102,"name":"Cheryl Stone","orcid":null,"position":8,"is_corresponding":false},{"id":645798,"name":"Julie Sullivan","orcid":"0000-0002-5681-747X","position":9,"is_corresponding":false},{"id":277466,"name":"Miriam B. Vos","orcid":"0000-0002-0817-7068","position":10,"is_corresponding":false},{"id":545503,"name":"Jean A. Welsh","orcid":"0000-0002-1372-5524","position":11,"is_corresponding":false},{"id":645795,"name":"Anna Wood","orcid":"0000-0002-5033-4629","position":12,"is_corresponding":false},{"id":24174,"name":"Greg S. Martin","orcid":"0000-0002-9684-7593","position":13,"is_corresponding":false},{"id":337554,"name":"Wilbur A. Lam","orcid":"0000-0002-0325-7990","position":14,"is_corresponding":false},{"id":376971,"name":"Nira R. Pollock","orcid":"0000-0002-6396-2915","position":15,"is_corresponding":false},{"id":928672,"name":"Adrianna Westbrook","orcid":"0000-0001-9309-6205","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-19T00:30:18.766838Z","pmid":"35271694","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}