TY - JOUR
T1 - Clinical features of COVID-19 for integration of COVID-19 into influenza surveillance
T2 - A systematic review
AU - Usher Network for COVID-19 Evidence Reviews (UNCOVER) group
AU - Lee, Bohee
AU - Ashcroft, Thulani
AU - Agyei-Manu, Eldad
AU - de Los, Emma F
AU - Leow, Amanda
AU - Krishan, Prerna
AU - Kulkarni, Durga
AU - Nundy, Madhurima
AU - Hartnup, Karen
AU - Shi, Ting
AU - McSwiggan, Emilie
AU - Nair, Harish
AU - Theodoratou, Evropi
AU - McQuillan, Ruth
N1 - Funding Information:
We acknowledge the UNCOVER research group for supporting this study. We thank Siddhivinay-ak Hirve and Aspen Hammond of the Global Influenza Programme, World Health Organization, Geneva, Switzerland for their support and Aspen Hammond for reviewing this paper.
Funding Information:
Funding: ET is supported by a Cancer Research UK Career Development Fellowship (C31250/A22804). BL is supported by the Asthma UK Centre for Applied Research for her PhD Program Fellowship. UNCOVER group is supported by Wellcome Trust’s Institutional Strategic Support Fund (ISSF3), the Data-Driven Innovation and the Principal’s Teaching Awards Scheme (PTAS). This work was commissioned by the Global Influenza Programme, World Health Organization, Geneva, Switzerland.
Publisher Copyright:
© 2022. The Author(s) JoGH. All Rights Reserved.
PY - 2022/4/14
Y1 - 2022/4/14
N2 - Background: In November 2020, the World Health Organization (WHO) created interim guidance on how to integrate testing for SARS-CoV-2 into existing influenza surveillance systems. Influenza-like illness (ILI) and severe acute respiratory illness (SARI) case definitions have been used to specify the case definition of COVID-19 for surveillance purposes. This review aims to assess whether the common clinical features of COVID-19 have changed to the point that the criteria used to identify both COVID-19 and influenza in surveillance programs needs to be altered.Methods: A systematic review of reviews following PRISMA-P guidelines was conducted using the "COVID-19 evidence review" database from August 19, 2020, to August 19, 2021. Reviews providing pooled estimates of the prevalence of clinical features of COVID-19 within the general population, diagnosed by polymerase chain reaction or rapid diagnostic test, were included. These were critically appraised and sensitivity analysis was undertaken to examine potential causes of bias.Results: Fourteen reviews were identified, including three on adults only and three on children only. For all reviews, combined fever (median prevalence = 73.0%, IQR = 58.3-78.7) and cough (45.1%, IQR = 28.9-54.0) were the most common features. These were followed by loss of taste or smell (45.1%, IQR = 28.9-54.0), hypoxemia (33%, one review), fatigue (26.4%, IQR = 9.0-39.4) and expectoration (23.9%, IQR = 23.3-25.5). Fever and cough continued to be the most prevalent features for adults and children, with subsequent symptoms being similar for adults only. However, the pattern differed for children, with headache (34.3%, IQR = 18-50.7) and nasal congestion (20%, one review) being the third and fourth commonest symptoms.Conclusions: The prevalent features found in this recent review were the same as the ones identified at the beginning of the pandemic. Therefore, the current approach of using the ILI and SARI criteria which incorporate fever and cough will identify COVID-19 cases in addition to influenza. Interestingly, children may present with different features, as headaches and nasal congestion were more common in this group. Future research could examine this further and investigate whether symptomology changes with new variants of COVID-19.
AB - Background: In November 2020, the World Health Organization (WHO) created interim guidance on how to integrate testing for SARS-CoV-2 into existing influenza surveillance systems. Influenza-like illness (ILI) and severe acute respiratory illness (SARI) case definitions have been used to specify the case definition of COVID-19 for surveillance purposes. This review aims to assess whether the common clinical features of COVID-19 have changed to the point that the criteria used to identify both COVID-19 and influenza in surveillance programs needs to be altered.Methods: A systematic review of reviews following PRISMA-P guidelines was conducted using the "COVID-19 evidence review" database from August 19, 2020, to August 19, 2021. Reviews providing pooled estimates of the prevalence of clinical features of COVID-19 within the general population, diagnosed by polymerase chain reaction or rapid diagnostic test, were included. These were critically appraised and sensitivity analysis was undertaken to examine potential causes of bias.Results: Fourteen reviews were identified, including three on adults only and three on children only. For all reviews, combined fever (median prevalence = 73.0%, IQR = 58.3-78.7) and cough (45.1%, IQR = 28.9-54.0) were the most common features. These were followed by loss of taste or smell (45.1%, IQR = 28.9-54.0), hypoxemia (33%, one review), fatigue (26.4%, IQR = 9.0-39.4) and expectoration (23.9%, IQR = 23.3-25.5). Fever and cough continued to be the most prevalent features for adults and children, with subsequent symptoms being similar for adults only. However, the pattern differed for children, with headache (34.3%, IQR = 18-50.7) and nasal congestion (20%, one review) being the third and fourth commonest symptoms.Conclusions: The prevalent features found in this recent review were the same as the ones identified at the beginning of the pandemic. Therefore, the current approach of using the ILI and SARI criteria which incorporate fever and cough will identify COVID-19 cases in addition to influenza. Interestingly, children may present with different features, as headaches and nasal congestion were more common in this group. Future research could examine this further and investigate whether symptomology changes with new variants of COVID-19.
U2 - 10.7189/jogh.12.05012
DO - 10.7189/jogh.12.05012
M3 - Article
C2 - 35567582
SN - 2047-2978
VL - 12
SP - 05012
JO - Journal of Global Health
JF - Journal of Global Health
ER -