Clinical characteristics of 51,815 patients presenting with positive and negative SARS-CoV-2 swab results in primary health care settings: Priority populations for vaccination

Abstract

We read with interest Brendish et al. study on the comparison between patients with SARS-CoV-2 positive and negative swab results.1 The study compared the clinical characteristics of adult hospitalised patients with SARS-CoV-2 infections positive and negative results. Brendish et al. reported that different health comorbidities including, hypertension, diabetes, chronic kidney disease, chronic liver disease did not differ significantly between both groups. On the other hand, patients with COPD, smokers were less often presented among patients with positive rt-PCR swab results in hospitalised patients. They suggested that the lower the presentation of current smokers and patients with COPD may be linked, and they have noted that other studies associated smoking with worse disease outcomes. The study is of significance as earlier research studies reported the characteristics of hospitalised patients with no comparator groups.2 , 3 , 4 , 5 , 6 To our knowledge, there are no studies to report on the clinical characteristics of patients with SARS-CoV-2 in primary care settings with comparison groups. The SARS-CoV-2 presentations in primary care settings reflect mild-to-moderate form of the disease, which presents different cohort of patients to hospitalised patients. Following the methodology used by Bendish et al. study, this record-based study compares the demographics and comorbidities among patients attending primary health care corporation (PHCC) with a suspected diagnosis of SARS-CoV-2 infection. PHCC is a governmental institution that runs 27 health centres in Qatar. The study population included all adult patients attending primary health care corporation from February 10th, 2020 to July 30th, 2020. Inclusion criteria included all adult patients with a documented diagnosis of a suspected diagnosis of SARS-CoV-2 infection and a documented rt-PCR swab result during the study period. Comparison groups are based on rt-PCR positive and negative results. Patients with more than one result were considered positive if any of the results is positive. Patients with inconclusive results were excluded from the analysis. The study examines and compares demographics and clinical characteristics of adult patients presenting to primary health care settings testing positive and negative for SARS-CoV-2 rt-PCR, using electronic medical records. The comparison might reflect which clinical characteristics might increase the risk of infection rather than predict the outcomes. The result might inform both public health policies and vaccination guidelines.