Analyzing factors affecting positivity in drive-through COVID-19 testing: a cross-sectional study

Masahiko Mori; Kazuaki Yokoyama; Riri Sanuki; Fumio Inoue; Takafumi Maekawa; Tadayoshi Moriyama

doi:10.1186/s12985-024-02388-w

Analyzing factors affecting positivity in drive-through COVID-19 testing: a cross-sectional study

Virol J. 2024 May 14;21(1):111. doi: 10.1186/s12985-024-02388-w.

Authors

Masahiko Mori¹, Kazuaki Yokoyama², Riri Sanuki³, Fumio Inoue⁴, Takafumi Maekawa^{5

6}, Tadayoshi Moriyama⁷

Affiliations

¹ Department of Internal Medicine, Sasebo Memorial Hospital, Sasebo, Nagasaki, 858-0922, Japan. medicaloffice@kinenhp.or.jp.
² Sasebo city medical association, Sasebo, Nagasaki, 857-0801, Japan.
³ Department of Health and Welfare, Sasebo city office, Sasebo, Nagasaki, 857-0042, Japan.
⁴ Sasebo city Health Center, Sasebo, Nagasaki, 857-0042, Japan.
⁵ Department of Surgery, Sasebo Memorial Hospital, Sasebo, Nagasaki, 858-0922, Japan.
⁶ Department of Surgery, Fukuoka Central Hospital, Fukuoka, Fukuoka, 810-0022, Japan.
⁷ Department of Neurosurgery, Sasebo Memorial Hospital, Sasebo, Nagasaki, 858-0922, Japan.

Abstract

Background: Demand for COVID-19 testing prompted the implementation of drive-through testing systems. However, limited research has examined factors influencing testing positivity in this setting.

Methods: From October 2020 to March 2023, a total of 1,341 patients, along with their clinical information, were referred from local clinics to the Sasebo City COVID-19 drive-through PCR center for testing. Association between clinical information or factors related to the drive-through center and testing results was analyzed by Fisher's exact test and logistic regression models.

Results: Individuals testing positive exhibited higher frequencies of upper respiratory symptoms; cough (OR 1.5 (95% CI 1.2-1.8), p < 0.001, q = 0.005), sore throat (OR 2.4 (95% CI 1.9-3.0), p < 0.001, q < 0.001), runny nose (OR 1.4 (95% CI 1.1-1.8), p = 0.002, q = 0.009), and systemic symptoms; fever (OR 1.5 (95% CI 1.1-2.0), p = 0.006, q = 0.02), headache (OR 1.9 (95% CI 1.4-2.5), p < 0.001, q < 0.001), and joint pain (OR 2.7 (95% CI 1.8-4.1), p < 0.001, q < 0.001). Conversely, gastrointestinal symptoms; diarrhea (OR 0.2 (95% CI 0.1-0.4), p < 0.001, q < 0.001) and nausea (OR 0.3 (95% CI 0.1-0.6), p < 0.001, q < 0.001) were less prevalent among positives. During omicron strain predominant period, higher testing positivity rate (OR 20 (95% CI 13-31), p < 0.001) and shorter period from symptom onset to testing (3.2 vs. 6.0 days, p < 0.001) were observed compared to pre-omicron period. Besides symptoms, contact history with infected persons at home (OR 4.5 (95% CI 3.1-6.5), p < 0.001, q < 0.001) and in office or school (OR 2.9 (95% CI 2.1-4.1), p < 0.001, q < 0.001), as well as the number of sample collection experiences by collectors (B 7.2 (95% CI 2.8-12), p = 0.002) were also associated with testing results.

Conclusions: These findings underscore the importance of factors related to drive-through centers, especially contact history interviews and sample collection skills, for achieving higher rates of COVID-19 testing positivity. They also contribute to enhanced preparedness for next infectious disease pandemics.

Keywords: COVID-19; Contact history; Drive-through testing; Omicron; Sample collection technique; Symptoms.

MeSH terms

Adolescent
Adult
Aged
COVID-19 Testing* / methods
COVID-19* / diagnosis
COVID-19* / epidemiology
COVID-19* / virology
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
SARS-CoV-2* / isolation & purification
Young Adult