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Temperature Screening for SARS-CoV-2 in Nursing Homes: Evidence from Two National Cohorts.
McConeghy, Kevin W; White, Elizabeth; Panagiotou, Orestis A; Santostefano, Christopher; Halladay, Christopher; Feifer, Richard A; Blackman, Carolyn; Rudolph, James L; Mor, Vince; Gravenstein, Stefan.
Afiliación
  • McConeghy KW; Department of Veterans Affairs, Center on Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.
  • White E; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA.
  • Panagiotou OA; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA.
  • Santostefano C; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA.
  • Halladay C; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA.
  • Feifer RA; Department of Veterans Affairs, Center on Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.
  • Blackman C; Genesis HealthCare, Kennett Square, Pennsylvania, USA.
  • Rudolph JL; Genesis HealthCare, Kennett Square, Pennsylvania, USA.
  • Mor V; Department of Veterans Affairs, Center on Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.
  • Gravenstein S; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA.
J Am Geriatr Soc ; 68(12): 2716-2720, 2020 12.
Article en En | MEDLINE | ID: mdl-33034046
BACKGROUND/OBJECTIVES: Infection screening tools classically define fever as 38.0°C (100.4°F). Frail older adults may not mount the same febrile response to systemic infection as younger or healthier individuals. We evaluate temperature trends among nursing home (NH) residents undergoing diagnostic SARS-CoV-2 testing and describe the diagnostic accuracy of temperature measurements for predicting test-confirmed SARS-CoV-2 infection. DESIGN: Retrospective cohort study evaluating diagnostic accuracy of pre-SARS-CoV-2 testing temperature changes. SETTING: Two separate NH cohorts tested diagnostically (e.g., for symptoms) for SARS-CoV-2. PARTICIPANTS Veterans residing in Veterans Affairs (VA) managed NHs and residents in a private national chain of community NHs. MEASUREMENTS: For both cohorts, we determined the sensitivity, specificity, and Youden's index with different temperature cutoffs for SARS-CoV-2 polymerase chain reaction results. RESULTS: The VA cohort consisted of 1,301 residents in 134 facilities from March 1, 2020, to May 14, 2020, with 25% confirmed for SARS-CoV-2. The community cohort included 3,368 residents spread across 282 facilities from February 18, 2020, to June 9, 2020, and 42% were confirmed for SARS-CoV-2. The VA cohort was younger, less White, and mostly male. A temperature testing threshold of 37.2°C has better sensitivity for SARS-CoV-2, 76% and 34% in the VA and community NH, respectively, versus 38.0°C with 43% and 12% sensitivity, respectively. CONCLUSION: A definition of 38.0°C for fever in NH screening tools should be lowered to improve predictive accuracy for SARS-CoV-2 infection. Stakeholders should carefully consider the impact of adopting lower testing thresholds on testing availability, cost, and burden on staff and residents. Temperatures alone have relatively low sensitivity/specificity, and we advocate any threshold be used as part of a screening tool, along with other signs and symptoms of infection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Temperatura Corporal / Envejecimiento / Termografía / Servicios de Salud para Veteranos / COVID-19 / Casas de Salud Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Am Geriatr Soc Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Temperatura Corporal / Envejecimiento / Termografía / Servicios de Salud para Veteranos / COVID-19 / Casas de Salud Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Am Geriatr Soc Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos