Dataset Information

Temperature Screening for SARS-CoV-2 in Nursing Homes: Evidence from Two National Cohorts.

ABSTRACT:

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.

SUBMITTER: McConeghy KW

PROVIDER: S-EPMC7675320 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Temperature Screening for SARS-CoV-2 in Nursing Homes: Evidence from Two National Cohorts.

McConeghy Kevin W KW White Elizabeth E Panagiotou Orestis A OA Santostefano Christopher C Halladay Christopher C Feifer Richard A RA Blackman Carolyn C Rudolph James L JL Mor Vince V Gravenstein Stefan S

Journal of the American Geriatrics Society 20201020 12

<h4>Background/objectives</h4>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.<h4>Design</h4>Retrospective cohort study evaluating diagn ...[more]

PMID: 33034046

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Dataset Information

Temperature Screening for SARS-CoV-2 in Nursing Homes: Evidence from Two National Cohorts.

Background/objectives

Design

Setting

Measurements

Results

Conclusion

Publications

Temperature Screening for SARS-CoV-2 in Nursing Homes: Evidence from Two National Cohorts.

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