Factors associated with COVID-19 viral and antibody test positivity and assessment of test concordance: a retrospective cohort study using electronic health records from the USA.
BMJ Open
; 11(10): e051707, 2021 10 01.
Article
em En
| MEDLINE
| ID: mdl-34598988
ABSTRACT
OBJECTIVES:
To identify factors associated with COVID-19 test positivity and assess viral and antibody test concordance.DESIGN:
Observational retrospective cohort study.SETTING:
Optum de-identified electronic health records including over 700 hospitals and 7000 clinics in the USA.PARTICIPANTS:
There were 891 754 patients who had a COVID-19 test identified in their electronic health record between 20 February 2020 and 10 July 2020. PRIMARY AND SECONDARY OUTCOMEMEASURES:
Per cent of viral and antibody tests positive for COVID-19 ('positivity rate'); adjusted ORs for factors associated with COVID-19 viral and antibody test positivity; and per cent concordance between positive viral and subsequent antibody test results.RESULTS:
Overall positivity rate was 9% (70 472 of 771 278) and 12% (11 094 of 91 741) for viral and antibody tests, respectively. Positivity rate was inversely associated with the number of individuals tested and decreased over time across regions and race/ethnicities. Antibody test concordance among patients with an initial positive viral test was 91% (71%-95% depending on time between tests). Among tests separated by at least 2 weeks, discordant results occurred in 7% of patients and 9% of immunocompromised patients. Factors associated with increased odds of viral and antibody positivity in multivariable models included male sex, Hispanic or non-Hispanic black or Asian race/ethnicity, uninsured or Medicaid insurance and Northeast residence. We identified a negative dose effect between the number of comorbidities and viral and antibody test positivity. Paediatric patients had reduced odds (OR=0.60, 95% CI 0.57 to 0.64) of a positive viral test but increased odds (OR=1.90, 95% CI 1.62 to 2.23) of a positive antibody test compared with those aged 18-34 years old.CONCLUSIONS:
This study identified sociodemographic and clinical factors associated with COVID-19 test positivity and provided real-world evidence demonstrating high antibody test concordance among viral-positive patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Registros Eletrônicos de Saúde
/
COVID-19
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article