Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease

Struyf, Thomas; Deeks, Jonathan J; Dinnes, Jacqueline; Takwoingi, Yemisi; Davenport, Clare; Leeflang, Mariska; Spijker, René; Hooft, Lotty; Emperador, Devy; Dittrich, Sabine; Domen, Julie; Horn, Sebastiaan R A; Bruel, Ann Van den

doi:10.1002/14651858.cd013665

Cited by 494 publications

(489 citation statements)

References 34 publications

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“…There are four statuses namely Green, Yellow, Orange and Red of which Singapore is at orange currently which meant that the disease is severe but has not spread widely and is being contained Pregnant women should also avoid missing prenatal appointments if well and limit interactions with others to reduce the risk of transmission. Symptomatic women should be urged to be tested early for COVID-19 by nasopharyngeal or oropharyngeal swabs and practice self-isolation to reduce the risk of vertical transmission [18][19].…”

Section: Discussionmentioning

confidence: 99%

“…Coronavirus disease (COVID- 19) is an infectious disease caused by a newly discovered severe acute respiratory syndrome coronavirus (SARS-CoV-2) rst identi ed in Wuhan City, China, in December 2019 [1]. On 11 th March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak as a global pandemic with exponential spread worldwide [2].…”

Section: Introductionmentioning

confidence: 99%

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Attitude and perceptions towards COVID-19 among pregnant women in Singapore: A cross-sectional survey

Lee

Loy

Yang

et al. 2020

Preprint

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Background COVID-19 may predispose pregnant women to higher risks of severe disease and poorer neonatal outcome. Psychological sequalae of this pandemic may pose a greater conundrum than its clinical aspects. It is currently unknown that how pregnant women cope with this global pandemic and its ramifications. The aims of the study are to understand the attitude and perceptions of non-infected pregnant women towards the COVID-19 outbreak in Singapore. Methods An online cross-sectional survey of COVID-19 awareness among pregnant women attending antenatal clinics in Singapore was conducted. An internet link was provided to complete an online electronic survey on Google platform using a quick response (QR) code on mobile devices. The online survey consists of 34 questions that were categorized into 4 main sections, namely 1) social demographics 2) attitude on safe distancing measures 3) precaution practices and 4) perceptions of COVID-19. Results A total of 167 survey responses were obtained over eight weeks from April to June 2020. The majority of women were aged ≤35 years (76%, n=127), were of Chinese ethnicity (55%, n=91), attained tertiary education (62%, n=104) and were not working as frontline staff (70%). Using multiple linear regression models, Malay ethnicity (vs. Chinese, β 0.24; 95% CI 0.04, 0.44) was associated with higher frequency of practicing social distancing. Malay women (β 0.48; 95% CI 0.16, 0.80) and those who worked as frontline staff (β 0.28; 95% CI 0.01, 0.56) sanitized their hands at higher frequencies. Age of ≥36 years (vs. ≤30 years, β 0.24; 95% CI 0.01, 0.46), Malay (vs. Chinese, β 0.27; 95% CI 0.06, 0.48) and Indian ethnicity (vs. Chinese, β 0.41; 95% CI 0.02, 0.80), and attendance at high-risk clinic (vs. general clinic, β 0.20; 95% CI 0.01, 0.39) were associated with higher frequency of staying-at-home.Conclusion It is important for clinicians to render appropriate counselling and focused clarification on the effect of COVID-19 among pregnant women for psychological support and mental wellbeing.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Attitude and perceptions towards COVID-19 among pregnant women in Singapore: A cross-sectional survey

Lee

Loy

Yang

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…In total, searches identified 32 symptoms associated with COVID-19 presentation from 10 guidelines, 1 , 3 , 15 – 22 13 published reviews, 23 – 35 and 12 preprint reviews. 36 – 47 See Table 1 for the list of symptoms and proposed corresponding SNOMED CT codes.…”

Section: Resultsmentioning

confidence: 99%

Recording COVID-19 consultations: review of symptoms, risk factors, and proposed SNOMED CT terms

et al. 2020

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BackgroundThere is an urgent need for epidemiological research in primary care to develop risk assessment processes for patients presenting with COVID-19, but lack of a standardised approach to data collection is a significant barrier to implementation.AimTo collate a list of relevant symptoms, assessment items, demographics, and lifestyle and health conditions associated with COVID-19, and match these data items with corresponding SNOMED CT clinical terms to support the development and implementation of consultation templates.Design & settingPublished and preprint literature for systematic reviews, meta-analyses, and clinical guidelines describing the symptoms, assessment items, demographics, and/or lifestyle and health conditions associated with COVID-19 and its complications were reviewed. Corresponding clinical concepts from SNOMED CT, a widely used structured clinical vocabulary for electronic primary care health records, were identified.MethodGuidelines and published and unpublished reviews (N = 61) were utilised to collate a list of relevant data items for COVID-19 consultations. The NHS Digital SNOMED CT Browser was used to identify concept and descriptive identifiers. Key implementation challenges were conceptualised through a Normalisation Process Theory (NPT) lens.ResultsIn total, 32 symptoms, eight demographic and lifestyle features, 25 health conditions, and 20 assessment items relevant to COVID-19 were identified, with proposed corresponding SNOMED CT concepts. These data items can be adapted into a consultation template for COVID-19. Key implementation challenges include: 1) engaging with key stakeholders to achieve ’buy in’; and 2) ensuring any template is usable within practice settings.ConclusionConsultation templates for COVID-19 are needed to standardise data collection, facilitate research and learning, and potentially improve quality of care for COVID-19.

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“…Areas that merit further study include the causal relationship between the infection and skin lesions, the role of pathogenic mechanisms, the absolute frequency and the frequency of skin lesions at the onset, as well as the disease course, the severity, and the transmission rate when skin involvement is the unique manifestation of the COVID-19. More in general, our knowledge regarding the diagnostic accuracy of signs and symptoms to determine if a patient is affected by SARS-CoV-2 infection is still limited at the point that a recent Cochrane review concluded that, “based on currently available data, neither absence nor presence of signs or symptoms are accurate enough to rule in or rule out disease” [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

An itchy erythematous papular skin rash as a possible early sign of COVID-19: a case report

et al. 2020

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Background Several recent studies suggest the possibility of a skin rash being a clinical presentation of coronavirus disease 2019 (COVID-19). The purpose of this case report is to bring attention to skin manifestations in the early stage of COVID-19 in order to support frontline physicians in their crucial activity of case identification. Case presentation The patient is an Italian 32-year-old female nurse who had several close contacts with multiple patients with COVID-19 as part of her professional workload. On March 13, 2020, the patient developed an itchy, erythematous papular rash (sparing only her face, scalp, and abdomen), which lasted for 10 days. The rash was accompanied by a feeling of general fatigue that gradually worsened over the following days and has continued for 5 months (until the end of July 2020). During the first week of remote assessment carried out by her general practitioner, the patient gradually developed a dry cough, intermittent fever, and diarrhoea and then had a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Her skin manifestations disappeared completely 48 days after the onset of the disease, followed by the disappearance of the dry cough. Conclusions In light of recent studies, this case report suggests that skin manifestations, when taken into account with other situational factors (such as profession and patient history) should be taken into proper consideration by frontline physicians as possibly being caused by SARS-CoV-2. Early identification of COVID-19 is a key part of the strategy of case detection and case isolation. To enhance this activity, further research is needed to establish frequency, symptoms, signs, and pathogenesis of skin manifestations in patients with COVID-19.

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Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease

Cited by 494 publications

References 34 publications

Attitude and perceptions towards COVID-19 among pregnant women in Singapore: A cross-sectional survey

Attitude and perceptions towards COVID-19 among pregnant women in Singapore: A cross-sectional survey

Recording COVID-19 consultations: review of symptoms, risk factors, and proposed SNOMED CT terms

An itchy erythematous papular skin rash as a possible early sign of COVID-19: a case report

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Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease

Cited by 494 publications

References 34 publications

Attitude and perceptions towards&nbsp;COVID-19 among pregnant women in Singapore: A cross-sectional survey

Attitude and perceptions towards&nbsp;COVID-19 among pregnant women in Singapore: A cross-sectional survey

Recording COVID-19 consultations: review of symptoms, risk factors, and proposed SNOMED CT terms

An itchy erythematous papular skin rash as a possible early sign of COVID-19: a case report

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Product

Resources

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Attitude and perceptions towards COVID-19 among pregnant women in Singapore: A cross-sectional survey

Attitude and perceptions towards COVID-19 among pregnant women in Singapore: A cross-sectional survey