Clinical Recommendation for Emergency Physicians to Approach to Signs and Symptoms Related to COVID-19; a Preliminary Study

Keywords:
Clinical Decision Rules, COVID-19, Probability, Risk Assessment, Signs and Symptoms

Abstract

Introduction: There is not enough and comprehensive evidence on signs and symptoms of COVID-19; therefore, it seems too early to provide an appropriate clinical decision-making rule for this newly emerged pandemic viral disease. Objective: We tried to categorize patients’ signs and symptoms from very highly suspected to non-suspected, regarding having COVID-19. Methods: Most recently published English-language articles on COVID-19, were reviewed by the researchers. We considered each complaint, separately, and gathered available data, such as percentage of involved patients and their crude number. Then we considered the pooled and collected results as the final percentage of the occurrence of every specific symptom. We categorized patients’ complaints into six types, based on the data obtained. All extracted complaints were categorized and scored. Results: Twenty-seven articles were reviewed, of which, 12 considered for analysis. The selected papers had reported various numbers of patients, ranging from 16 to 1,099 patients (mean=229 patients per study). In total, nineteen different complaints, with an average of nine complaints per article, had been reported (IQR= 8-11). In terms of overall prevalence, based on the total number of patients, fever and dry cough were reported in more than half of the referred patients. The complaints were categorized in six types with and scored. Conclusions: The patients with score ≥17 are very highly suspected to COVID-19; However, patients with score <5 could be considered as non-suspected to COVID-19.

Downloads

Download data is not yet available.

References

1. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). 16-24 February 2020. [Avaiable from: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf].
2. Han C, Duan C, Zhang S, Spiegel B, Shi H, Wang W, et al. Digestive Symptoms in COVID-19 Patients with Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes. Am J Gastroenterol. 2020; Epub ahead of print.
3. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
4. Darlenski R, Tsankov N. COVID-19 pandemic and the skin: what should dermatologists know? Clin Dermatol. 2020; Epub ahead of print.
5. Lovato A, de Filippis C. Clinical Presentation of COVID-19: A Systematic Review Focusing on Upper Airway Symptoms. Ear Nose Throat J. 2020; Epub ahead of print.
6. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
7. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020:200463.
8. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
9. Chang D, Mo G, Yuan X, Tao Y, Peng X, Wang FS, et al. Time Kinetics of Viral Clearance and Resolution of Symptoms in Novel Coronavirus Infection. Am J Respir Crit Care Med. 2020;201(9):1150-2.
10. Zheng Y, Xiong C, Liu Y, Qian X, Tang Y, Liu L, et al. Epidemiological and Clinical Characteristics Analysis of COVID-19 in the Surrounding Areas of Wuhan, Hubei Province in 2020. Pharmacol Res. 2020; Epub ahead of print.
11. Yu X, Sun X, Cui P, Pan H, Lin S, Han R, et al. Epidemiological and Clinical Characteristics of 333 Confirmed Cases with Coronavirus Disease 2019 in Shanghai, China. Transbound Emerg Dis. 2020; Epub ahead of print.
12. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS- CoV-2 in Wuhan, China. Allergy. 2020; Epub ahead of print.
13. Wang L, Duan Y, Zhang W, Liang J, Xu J, Zhang Y, et al. Epidemiologic and Clinical Characteristics of 26 Cases of COVID-19 Arising from Patient-to-Patient Transmission in Liaocheng, China. Clin Epidemiol. 2020;12:387-91.
14. Li Y, Xia L. Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management. Am J Roentgenol. AJR Am J Roentgenol. 2020;214(6):1280-6.
15. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
Published
2020-05-28
How to Cite
1.
Nejati A, Afzalimoghaddam M, Seyedhosseini-Davarani S, Akhgar A. Clinical Recommendation for Emergency Physicians to Approach to Signs and Symptoms Related to COVID-19; a Preliminary Study. Adv J Emerg Med. 4(2s):e56.
Section
Brief report