{"id":"https://openalex.org/W7214935440","doi":"https://doi.org/10.3389/fpubh.2026.1908390","title":"Hospital SARS-CoV-2 surveillance across inpatient testing, fever clinic, and general outpatient settings: positivity, Ct gradients, and short-lag warning signals","display_name":"Hospital SARS-CoV-2 surveillance across inpatient testing, fever clinic, and general outpatient settings: positivity, Ct gradients, and short-lag warning signals","publication_year":2026,"publication_date":"2026-09-30","ids":{"openalex":"https://openalex.org/W7214935440","doi":"https://doi.org/10.3389/fpubh.2026.1908390","pmid":"https://pubmed.ncbi.nlm.nih.gov/42876616","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13661547"},"language":"en","primary_location":{"id":"doi:10.3389/fpubh.2026.1908390","doi":"https://doi.org/10.3389/fpubh.2026.1908390","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1908390","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1908390/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1908390/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5153581289","display_name":"Guanglin Cui","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210156804","display_name":"First Affiliated Hospital of Zhengzhou University","ror":"https://ror.org/056swr059","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210156804"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Guanglin Cui","raw_affiliation_strings":["Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","Key Laboratory of Laboratory Medicine of Henan Province"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","institution_ids":["https://openalex.org/I4210156804"]},{"raw_affiliation_string":"Key Laboratory of Laboratory Medicine of Henan Province","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5065623863","display_name":"Ning Song","orcid":"https://orcid.org/0000-0003-1743-9637","observed_orcids":["https://orcid.org/0000-0003-1743-9637","https://orcid.org/0009-0004-2134-6788"]},"institutions":[{"id":"https://openalex.org/I4210156804","display_name":"First Affiliated Hospital of Zhengzhou University","ror":"https://ror.org/056swr059","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210156804"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Ning Song","raw_affiliation_strings":["Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University","institution_ids":["https://openalex.org/I4210156804"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5014265058","display_name":"Wanhai Wang","orcid":"https://orcid.org/0000-0001-5354-5627","observed_orcids":["https://orcid.org/0000-0001-5354-5627","https://orcid.org/0009-0000-6486-5319"]},"institutions":[{"id":"https://openalex.org/I4210156804","display_name":"First Affiliated Hospital of Zhengzhou University","ror":"https://ror.org/056swr059","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210156804"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Wanhai Wang","raw_affiliation_strings":["Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","Key Laboratory of Laboratory Medicine of Henan Province"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","institution_ids":["https://openalex.org/I4210156804"]},{"raw_affiliation_string":"Key Laboratory of Laboratory Medicine of Henan Province","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5014265058","https://openalex.org/A5065623863"],"corresponding_institution_ids":["https://openalex.org/I4210156804"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.70604489,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"14","issue":null,"first_page":"1908390","last_page":"1908390"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11754","display_name":"SARS-CoV-2 detection and testing","score":0.48339998722076416,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11754","display_name":"SARS-CoV-2 detection and testing","score":0.48339998722076416,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10410","display_name":"COVID-19 epidemiological studies","score":0.30979999899864197,"subfield":{"id":"https://openalex.org/subfields/2611","display_name":"Modeling and Simulation"},"field":{"id":"https://openalex.org/fields/26","display_name":"Mathematics"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11819","display_name":"Data-Driven Disease Surveillance","score":0.08179999887943268,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/sars-cov-2","display_name":"SARS-CoV-2","score":0.9200000166893005},{"id":"https://openalex.org/keywords/covid-19-surveillance","display_name":"COVID-19 surveillance","score":0.777999997138977},{"id":"https://openalex.org/keywords/hospital-based-surveillance","display_name":"hospital surveillance","score":0.6200000047683716},{"id":"https://openalex.org/keywords/fever-clinic","display_name":"fever clinic","score":0.6740000247955322},{"id":"https://openalex.org/keywords/inpatient-testing","display_name":"inpatient testing","score":0.9010000228881836},{"id":"https://openalex.org/keywords/cycle-threshold","display_name":"cycle threshold","score":0.6510000228881836},{"id":"https://openalex.org/keywords/positivity","display_name":"positivity","score":0.39899998903274536},{"id":"https://openalex.org/keywords/early-warning-indicators","display_name":"early warning indicators","score":0.8700000047683716},{"id":"https://openalex.org/keywords/time-lagged-correlation","display_name":"time-lagged correlation","score":0.7049999833106995},{"id":"https://openalex.org/keywords/infection-control","display_name":"infection control","score":0.7289999723434448}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9003999829292297},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.6147000193595886},{"id":"https://openalex.org/C3020110884","wikidata":"https://www.wikidata.org/wiki/Q695416","display_name":"Outpatient clinic","level":2,"score":0.5849999785423279},{"id":"https://openalex.org/C2909321700","wikidata":"https://www.wikidata.org/wiki/Q181600","display_name":"Outpatient visits","level":3,"score":0.510699987411499},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.4973999857902527},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.4871000051498413},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.4740000069141388},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.459199994802475},{"id":"https://openalex.org/C2992019943","wikidata":"https://www.wikidata.org/wiki/Q16917","display_name":"General hospital","level":2,"score":0.4041999876499176},{"id":"https://openalex.org/C64869954","wikidata":"https://www.wikidata.org/wiki/Q1859747","display_name":"False positive paradox","level":2,"score":0.3804999887943268},{"id":"https://openalex.org/C124306116","wikidata":"https://www.wikidata.org/wiki/Q2512965","display_name":"Ambulatory care","level":3,"score":0.37380000948905945},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.33980000019073486},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3319000005722046},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3310000002384186},{"id":"https://openalex.org/C2777671062","wikidata":"https://www.wikidata.org/wiki/Q6889402","display_name":"Early warning score","level":2,"score":0.3050999939441681},{"id":"https://openalex.org/C2777267654","wikidata":"https://www.wikidata.org/wiki/Q3519023","display_name":"Test (biology)","level":2,"score":0.28610000014305115},{"id":"https://openalex.org/C29825287","wikidata":"https://www.wikidata.org/wiki/Q1427940","display_name":"Warning system","level":2,"score":0.26980000734329224},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.25609999895095825}],"mesh":[{"descriptor_ui":"D000086382","descriptor_name":"COVID-19","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D000086382","descriptor_name":"COVID-19","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D000086402","descriptor_name":"SARS-CoV-2","qualifier_ui":"Q000302","qualifier_name":"isolation & purification","is_major_topic":false},{"descriptor_ui":"D000087123","descriptor_name":"COVID-19 Nucleic Acid Testing","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002681","descriptor_name":"China","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005334","descriptor_name":"Fever","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007297","descriptor_name":"Inpatients","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010045","descriptor_name":"Outpatients","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D012189","descriptor_name":"Retrospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.3389/fpubh.2026.1908390","doi":"https://doi.org/10.3389/fpubh.2026.1908390","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1908390","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1908390/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13661547","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13661547/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13661547/pdf/fpubh-14-1908390.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Public Health","raw_type":"Text"},{"id":"pmid:42876616","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42876616","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in public health","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:1c6a9d1f58584395aa0585caf1338903","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/1c6a9d1f58584395aa0585caf1338903","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Public Health, Vol 14 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fpubh.2026.1908390","doi":"https://doi.org/10.3389/fpubh.2026.1908390","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1908390","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1908390/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7214935440.pdf","grobid_xml":"https://content.openalex.org/works/W7214935440.grobid-xml"},"referenced_works_count":25,"referenced_works":["https://openalex.org/W3048075106","https://openalex.org/W3085490503","https://openalex.org/W3114486515","https://openalex.org/W3135289648","https://openalex.org/W3161410581","https://openalex.org/W3166719420","https://openalex.org/W3180448484","https://openalex.org/W3197904967","https://openalex.org/W3216746548","https://openalex.org/W4206138580","https://openalex.org/W4212851280","https://openalex.org/W4225313556","https://openalex.org/W4309796690","https://openalex.org/W4311691594","https://openalex.org/W4318613815","https://openalex.org/W4382796394","https://openalex.org/W4385742401","https://openalex.org/W4386407554","https://openalex.org/W4391428708","https://openalex.org/W4394015584","https://openalex.org/W4398182292","https://openalex.org/W4404087595","https://openalex.org/W4405896425","https://openalex.org/W4415618362","https://openalex.org/W4416122180"],"related_works":["https://openalex.org/W3089140723","https://openalex.org/W3010603941","https://openalex.org/W4296808710","https://openalex.org/W4386252550","https://openalex.org/W4200032058","https://openalex.org/W4365814974","https://openalex.org/W4404337413","https://openalex.org/W4200013726","https://openalex.org/W3095218099","https://openalex.org/W4389032001"],"abstract_inverted_index":{"Background:":[0],"Hospital-based":[1],"SARS-CoV-2":[2,38],"surveillance":[3,200],"needs":[4],"to":[5],"distinguish":[6],"front-end":[7,199],"detection":[8],"settings":[9,117,174,213],"from":[10,43],"inpatient":[11,76,116,164,180,222],"testing":[12,77,181],"burden":[13,186],"and":[14,57,75,88,115,136,142],"evaluate":[15],"whether":[16],"outpatient":[17,113,144,151,193,212],"virological":[18,177],"signals":[19],"can":[20,214],"provide":[21,215],"early":[22,218],"warning":[23,219],"for":[24,220],"downstream":[25],"hospital":[26,227],"pressure.":[27],"Methods:":[28],"We":[29],"conducted":[30],"a":[31,167,197,204,216],"single-center":[32],"retrospective":[33],"observational":[34],"study":[35],"using":[36],"all":[37],"nucleic":[39],"acid":[40],"test":[41,67],"records":[42],"Zhengdong":[44],"Campus,":[45],"The":[46,61,147,191],"First":[47],"Affiliated":[48],"Hospital":[49],"of":[50,63,149,169,187],"Zhengzhou":[51],"University,":[52],"between":[53],"20":[54],"December":[55,59],"2022":[56],"31":[58],"2025.":[60],"unit":[62],"analysis":[64],"was":[65,103,131],"individual":[66],"specimens,":[68],"classified":[69],"into":[70],"fever":[71,107,139],"clinic,":[72],"general":[73,112,143,150,192],"outpatient,":[74],"groups.":[78],"Statistical":[79],"analyses":[80],"included":[81],"chi-square":[82],"tests,":[83,85,95],"non-parametric":[84],"logistic":[86],"regression,":[87],"time-lagged":[89],"correlation":[90],"analyses.":[91],"Results:":[92],"Among":[93,119],"24,751":[94],"5,000":[96],"were":[97],"positive":[98,121,188],"(overall":[99],"positivity":[100,165],"20.2%).":[101],"Positivity":[102],"highest":[104,132],"in":[105,133,138,211],"the":[106,158,183],"clinic":[108,140,194],"(26.9%),":[109],"followed":[110],"by":[111],"(23.5%)":[114],"(16.3%).":[118],"4,134":[120],"tests":[122],"with":[123,153,162],"available":[124],"cycle":[125],"threshold":[126],"(Ct)":[127],"values,":[128],"median":[129],"Ct":[130,154],"inpatients":[134],"(30.0)":[135],"lower":[137],"(28.0)":[141],"(27.0)":[145],"settings.":[146],"proportion":[148],"positives":[152],"<":[155],"25":[156],"showed":[157],"strongest":[159],"overall":[160],"association":[161],"subsequent":[163],"at":[166],"lag":[168],"2":[170],"biweekly":[171],"intervals.":[172],"Outpatient":[173],"concentrated":[175],"stronger":[176],"signals,":[178],"while":[179],"carried":[182],"largest":[184],"absolute":[185],"results.":[189],"Conclusion:":[190],"functions":[195],"as":[196],"meaningful":[198],"interface":[201],"rather":[202],"than":[203],"low-risk":[205],"background":[206],"category.":[207],"Monitoring":[208],"low-Ct":[209],"enrichment":[210],"pragmatic":[217],"short-term":[221],"pressure,":[223],"supporting":[224],"broader":[225],"outpatient-focused":[226],"infection":[228],"prevention":[229],"strategies.":[230]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-10-01T00:00:00"}
