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Many COVID-19 infected people remain asymptomatic, and hence the diagnosis at first presentation remains a challenge. Assessment at a presentation in primary care settings is usually done by visual triaging and basic clinical examination. This retrospective study involved investigating the medical e-records of COVID-19 positive patients who presented to a COVID-19 centre in Qatar for July 2020. The presence (symptomatic group) or the absence (asymptomatic group) of symptoms along with objective vital examination ( ie ; heart-rate (HR), temperature, haemoglobin saturation (SpO 2 )) were analysed and linked to the viral load ( ie ; cycle threshold (Ct)) of COVID-19 positive patients. Four hundred eighty-one symptomatic (230 males) and 216 asymptomatic (101 males) patients were included. Compared to the asymptomatic male group, the symptomatic male group was older, had lower Ct value and SpO 2 , and higher temperature and HR. Compared to the females asymptomatic group, the symptomatic females group had lower Ct value, and higher temperature. Compared to the asymptomatic group, the symptomatic group had lower Ct value and SpO 2 , and higher temperature and HR. Compared to the asymptomatic group, the symptomatic group had lower Ct values (age groups [21–30], [31–40], [41–50] and [51–60]), higher temperature (age groups [21–30] and [31–40], Ct ranges [20.01–25.00] and [25.01–30.00]), higher HR (age groups [21–30] and [31–40], Ct range [15.01–20.00]); and lower SpO 2 (age groups [41–50] and [51–60], Ct ranges [15.01–20.00] and [35.01–40.00]). Compared with asymptomatic patients, symptomatic patients with COVID-19 are most likely to be febrile, tachycardic, hypoxic and having higher viral load. Higher viral load was associated with higher HR, higher temperature, lower SpO 2 , but there was no relation between viral load and age.

With over 36 million people infected with COVID-19 since the beginning of the pandemic, testing has been most challenging process to identify and isolate individuals who are COVID-positive. The RT-PCR testing method has been the gold standard testing tool with a sensitivity and specificity of 95.2% and 98.9% respectively. However, this comes at a huge cost of the stress and anxieties of the testing process itself, especially for children as well as the requirements of health care professionals with PPE kits and the dangers of an aerosol generating procedure. We hence recommend the saliva testing kits as the suggested way forward to testing for the general population, especially for children, as they are highly sensitive and specific (98% and 91% respectively) as well as can be a much effortless process to test for COVID-19 and could certainly pave the way forward to mass testing as some countries are already planning to implement.

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