Clinical and virological course of COVID-19 patients seen in primary care consultation – COVID-A

Current knowledge of the natural history of COVID-19 is mainly based on the description of hospitalized cases, but, to our best knowledge, no data has been reported from the general population. In agreement with the COVID-19 research priorities identified by the WHO, and with the research topics targeted by this ANR Flash COVID-19 call, we propose here a study aiming to describe the natural history of the disease in an initial phase (i.e. in patients that will not require hospitalization, or before hospitalisation in those who will require it).
This research will be conducted based on an ongoing clinical and virological surveillance system implemented by the French Sentinelles network with the purpose of real-time monitoring of the COVID-19 activity in the general population in continental France. This surveillance system will allow us to rapidly include a random sample of out-patients tested against the SARS-CoV-2 consulting in primary care for an ARI. We will collect prospective clinical, epidemiological and virological data on these patients at different points in time, for a period of 30 days since the onset of symptoms. Clinical and epidemiological data will be collected through regular questionnaires implemented using validated methods. Such data include socio-economic status, health-related status (medical history, chronic pathology, BMI, current treatment), use of hygiene and containment measures, risk behaviour (such as tobacco use), further treatments and consultations and the evolution of clinical signs since the onset of the disease. Virological data will be collected based on a nasopharyngeal swab collected by the physician at inclusion in the study and saliva self-samples during the follow-up period.
First, we will describe the clinical and virological evolution of the disease, the time of symptoms alleviation, and the care management scheme according to patient profile. Then, we will study the clinical signs associated with a SARS-CoV-2 infection by comparing the symptoms of SARS-CoV-2 lab-confirmed patients with those observed in patients having tested negative for SARS-CoV-2. Finally, we will study the risk factors associated with an evolution into a severe case by comparing the characteristics of SARS-CoV-2 lab-confirmed patients evolving into a severe form to those of patients presenting a favourable evolution of the infection.
These data will allow a better understanding of the COVID-19 evolution in patients infected with the SARS-CoV-2 in the community in France, and represent an essential contribution to the public health response in the context of the ongoing COVID-19 epidemic.