Epidemiological and clinical characteristics of SARS-CoV-2 infections at a testing site in Berlin, Germany, March and April 2020-a cross-sectional study

Clin Microbiol Infect. 2020 Dec;26(12):1685.e7-1685.e12. doi: 10.1016/j.cmi.2020.08.017. Epub 2020 Aug 20.


Objective: In Berlin, the first public severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing site started 1 day after the first case in the city occurred. We describe epidemiological and clinical characteristics and aim at identifying risk factors for SARS-CoV-2 detection during the first 6 weeks of operation.

Methods: Testing followed national recommendations, but was also based on the physician's discretion. We related patient characteristics to SARS-CoV-2 test positivity for exploratory analyses using a cross-sectional, observational study design.

Results: Between 3 March and 13 April 2020, 5179 individuals attended the site (median age 34 years; interquartile range 26-47 years). The median time since disease onset was 4 days (interquartile range 2-7 days). Among 4333 persons tested, 333 (7.7%) were positive. Test positivity increased up to 10.3% (96/929) during the first 3 weeks and then declined, paralleling Germany's lock-down and the course of the epidemic in Berlin. Strict adherence to testing guidelines resulted in 10.4% (262/2530) test positivity, compared with 3.9% (71/1803) among individuals tested for other indications. A nightclub was a transmission hotspot; 27.7% (26/94) of one night's visitors were found positive. Smell and/or taste dysfunction indicated coronavirus disease 2019 (COVID-19) with 85.6% specificity (95% CI 82.1%-88.1%). Four per cent (14/333) of those infected were asymptomatic. Risk factors for detection of SARS-CoV-2 infection were recent contact with a positive case (second week after contact, OR 3.42; 95% CI 2.48-4.71), travel to regions of high pandemic activity (e.g. Austria, OR 4.16; 95% CI 2.48-6.99), recent onset of symptoms (second week, OR 3.61; 95% CI 1.87-6.98) and an impaired sense of smell/taste (4.08; 95% CI 2.36-7.03).

Conclusions: In this young population, early-onset presentation of COVID-19 resembled flu-like symptoms, except for smell and/or taste dysfunction. Risk factors for SARS-CoV-2 detection were return from regions with high incidence and contact with confirmed SARS-CoV-2 cases, particularly when tests were administered within the first 2 weeks after contact and/or onset of symptoms.

Keywords: Asymptomatic; Coronavirus; Coronavirus disease 2019; Olfaction disorders; Screening; Severe acute respiratory syndrome coronavirus 2.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Berlin / epidemiology
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 / physiopathology
  • COVID-19 Testing / methods
  • COVID-19 Testing / statistics & numerical data*
  • Carrier State / diagnosis
  • Carrier State / epidemiology*
  • Carrier State / virology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Male
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Olfaction Disorders / epidemiology
  • Olfaction Disorders / virology
  • Pandemics / statistics & numerical data
  • Risk Factors
  • Sensitivity and Specificity
  • Taste Disorders / epidemiology
  • Taste Disorders / virology