Characteristics associated with COVID-19 or other respiratory viruses’ infections at a single-center emergency department

Abstract

Background Rapid identification of patients with high suspicion of COVID-19 will become a challenge with the co-circulation of multiple respiratory viruses (RVs). We have identified clinical or biological characteristics to help distinguish SARS-CoV-2 from other RVs. Methods We used a prospective cohort including all consecutive patients admitted through the emergency department’s (ED) and presenting respiratory symptoms from November 2019 to April 2020. Patients were tested for RV using multiplex polymerase chain reaction (mPCR) and SARS-CoV-2 RT-PCR. Results 203/508 patients were positive for an RV during the non-SARS-CoV-2 epidemic period (November to February), and 268/596 patients were SARS-CoV-2 positive during the SARS-CoV-2 epidemic (March to April). Younger age, male gender, fever, absence of expectoration and absence of chronic lung disease were statistically associated with SARS-CoV-2 detection. Combining these variables allowed for the distinguishing of SARS-CoV-2 infections with 83, 65, 75 and 76% sensitivity, specificity, PPV and NPV, respectively. Conclusion Patients’ characteristics associated with a positive PCR are common between SARS-CoV-2 and other RVs, but a simple discrimination of strong SARS-CoV-2 suspicion with a limited set of clinical features seems possible. Such scoring could be useful but has to be prospectively evaluated and will not eliminate the need for rapid PCR assays.

Performance of Diagnostic Model for Differentiating Between COVID-19 and Influenza: A 2-Center Retrospective Study

“…Fever was one of the markers in the predictive model. Patients with COVID-19 were more prone to have fever compared with those with influenza, which was consistent with a previous study [ 25 ]. According to Zhong et al [ 45 ], about half of the patients had fever on initial presentation and fever developed in 87.9% of patients following hospitalization.…”

“…The strict quarantine measures and screening policies in China ensured that COVID-19 patients could get the earliest identification and medical treatments during the pandemic, which made the time from symptom onset to hospital admission shorter. Alternatively, some differences that exist among the current studies may be due to the use of different sample sizes [ 25 , 26 ]. Future studies with larger sample sizes could be done to validate the results of this study.…”

“…However, some studies were single-center studies with relatively small sample sizes or were based on single-dimension data such as biochemical indicators or clinical features [ 26 , 27 ]. Also, patients involved in another 2 studies were recruited from the Emergency Department, leading to selection bias [ 24 , 25 ]. Larger sample sizes, multidimensional data, and more representative patients are needed for a definitive conclusion.…”

Viral epidemiology and SARS‐CoV‐2 co‐infections with other respiratory viruses during the first COVID‐19 wave in Paris, France

“…The common symptoms of COVID‐19 are fever, cough, dyspnea, fatigue, myalgia, and diarrhea. Most of these symptoms are also falling within the definition of influenza‐like illness (ILI) 2,3 . In France, SARS‐CoV‐2 first wave struck from late February to the end of April, coinciding with the very end of the winter‐associated viruses' epidemic this year and raising the question of potential viral co‐infections with SARS‐CoV‐2 and their impact.…”

Viral epidemiology and SARS-CoV-2 coinfections with other respiratory viruses during the first COVID-19 wave in Paris, France

“…The common symptoms of COVID-19 are fever, cough, dyspnea, fatigue, myalgia, and diarrhea. Most of these symptoms are also falling within the definition of influenza-like illness [2,3]. In France, SARS-CoV-2 first wave struck from late February to the end of April, coinciding with the very end of the winter-associated viruses' epidemic this year and raising the question of potential viral co-infections with SARS-CoV-2 and their impact.…”