Buonafine 2020.

Study characteristics
Patient Sampling	Purpose: diagnosis of SARS‐CoV‐2 infection (mild COVID‐19 disease); to investigate the prevalence and clinical characteristics of HCWs with COVID‐19 symptoms Design: cross‐sectional cohort study, prospective data collection Recruitment: HCW from the Santa Casa de São Paulo Hospital were defined as symptomatic and invited to participate in the study if presented with self‐reported fever or symptoms suspicious of COVID‐19 Sample size: n = 295 (125 cases) Inclusion criteria: HCW with self‐reported fever or any of the following: acute respiratory symptoms (cough, nasal congestion, sore throat, shortness of breath), loss or changed sense of smell or taste, ocular symptoms, headache, arthralgia, myalgia, fatigue, diarrhoea, nausea, and vomiting Exclusion criteria: none specified
Patient characteristics and setting	Facility cases: RT‐PCR‐positive for SARS‐CoV‐2 Facility controls: RT‐PCR‐negative for SARS‐CoV‐2 Country: Brazil Dates: 21 March 2020‐22 May 2020 Symptoms and severity: mild to moderate to severe: 7% hospitalised 2% died, 91% of included individuals had headache, 88% nasal congestion, 85% cough, 85% fatigue, 81% myalgia Demographics: mean age cases 35 years, controls 34 years M%/F%: cases 40.0/60.0, controls 23.6/76.4 Exposure history: all HCW. Close contact with confirmed COVID‐19: cases 73%; controls 74%
Index tests	Headache Nasal congestion Cough Fatigue Myalgia Sore throat Chills Ocular pain Fever Arthralgia Diarrhoea Abdominal pain Shortness of breath Cutaneous rash Anosmia
Target condition and reference standard(s)	TC: SARS‐CoV‐2 infection RS: RT‐PCR for SARS‐CoV‐2 (nasopharyngeal and oropharyngeal swab)
Flow and timing	Timing not specified
Comparative
Notes	Funding: none declared
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Unclear
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	No
Did the study avoid inappropriate inclusions?	Yes
Could the selection of patients have introduced bias?		High risk
Are there concerns that the included patients and setting do not match the review question?			Low concern
DOMAIN 2: Index Test (All tests)
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
If a threshold was used, was it pre‐specified?	No
Could the conduct or interpretation of the index test have introduced bias?		High risk
Are there concerns that the index test, its conduct, or interpretation differ from the review question?			Low concern
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Yes
Were the reference standard results interpreted without knowledge of the results of the index tests?	Unclear
Could the reference standard, its conduct, or its interpretation have introduced bias?		Low risk
Are there concerns that the target condition as defined by the reference standard does not match the question?			Low concern
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Unclear
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Yes
Could the patient flow have introduced bias?		Unclear risk