Symptom profiles and accuracy of clinical case definitions for COVID-19 in a community cohort: results from the Virus Watch study

Background: Understanding symptomatology and accuracy of clinical case definitions for community COVID-19 cases is important Test, Trace Isolate (TTI) future targeting early antiviral treatment. Methods: Community cohort participants prospectively recorded daily symptoms swab results (mainly undertaken through the UK TTI system). We compared symptom frequency, severity, timing, duration in test positive negative illnesses. performance current definition (cough, high temperature, or loss altered sense smell taste) with a wider adding muscle aches, chills, headache, appetite. Results: Among 9706 swabbed illnesses, including 973 SARS-CoV-2 positives, were more common, severe longer lasting than Cough, fatigue, aches most common illnesses but also Conversely, taste appetite less frequent comparatively even The had 81% sensitivity 47% specificity versus 93% 27% respectively broader definition. 1.7-fold met Conclusions: Symptoms alone cannot reliably distinguish COVID-19 from other respiratory Adding additional to could identify infections, large increase number needing testing unwell individuals contacts self-isolating whilst awaiting results.