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. 2022 May 20;2022(5):CD013665. doi: 10.1002/14651858.CD013665.pub3

Just 2020.

Study characteristics
Patient Sampling Purpose: diagnosis of SARS‐CoV‐2 infection (mild COVID‐19 disease); to identify predictive risk factors for a positive SARS‐CoV‐2 RT‐PCR result in a primary care setting
Design: multicentre, cross‐sectional cohort study
Recruitment: 26 office‐based specialists for internal and/or general medicine with a full primary care mandate from 14 different locations participated in the study. Suspected COVID‐19 patients for whom a PCR was taken were included.
Sample size: n = 374 (40 cases)
Inclusion criteria: convenience sample of patients who received PCR in the participating GPs' practices within the study period
Exclusion criteria: patients whose tests had been carried out for procedural reasons and did not correspond to a specific clinical indication were excluded (e.g. testing of recovered patients after end of quarantine). There were no other exclusion criteria.
Patient characteristics and setting Facility cases: suspected patients with a positive PCR test
Facility controls: suspected patients with a negative PCR test
Country: Germany
Dates: 24 March 2020‐17 April 2020
Symptoms and severity: mild to moderate severity
Demographics: median age: cases: 52.0 years, controls: 43.5 years gender: % female cases: 65.0%, controls: 57.2%
Exposure history: first grade contact (with symptoms): cases: 35.0%, controls 17.4%
Index tests
  • Cough

  • Sore throat

  • Fatigue

  • Fever

  • Nasal congestion

  • Muscle pain

  • Dyspnoea

  • Headache

  • Anorexia

  • Anosmia

  • Diarrhoea

  • Chills

  • Nausea

  • Vomiting

  • Other

Target condition and reference standard(s)
  • TC: SARS‐CoV‐2 infection

  • RS: RT‐PCR, sample type not specified

Flow and timing RS and index tests both taken on admission
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? No    
Was a case‐control design avoided? Yes    
Did the study avoid inappropriate exclusions? Unclear    
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? Unclear    
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? Yes    
Did all patients receive the same reference standard? Yes    
Were all patients included in the analysis? Yes    
Could the patient flow have introduced bias?   Low risk