Symptom presentation of SARS-CoV-2-positive and negative patients: a nested case–control study among patients calling the emergency medical service and medical helpline

Møller, Amalie Lykkemark; Mills, Elisabeth Helen Anna; Christensen, Helle Collatz; Gnesin, Filip; Blomberg, Stig Nikolaj; Zylyftari, Nertila; Jensen, Boris Brorman; Ringgren, Kristian Bundgaard; Broccia, Marcella; Bøggild, Henrik; Torp‐Pedersen, Christian

doi:10.1136/bmjopen-2020-044208

Cited by 12 publications

(9 citation statements)

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“… Perspectives/ Experiences 37 Moeller et. al 49 Symptom presentation of SARS-CoV-2-positive and negative patients: a nested case-control study among patients calling the emergency medical service and medical helpline Case Clinical data from patient care reports Copenhagen, DK ● Loss of smell/taste as a symptom of Covid-19 was almost always reported for patients younger than 60. ● Fever and cough were the most common symptoms in all age groups.…”

Section: Resultsmentioning

confidence: 99%

“…In a prehospital study in Denmark, patients under 60 years old were more likely to present with a loss of taste and/or smell upon assessment, however fever and cough were equally distributed across all age groups. 49 In England, Marincowitz et al studied the accuracy of prognostic triage tools used prehospitally in the Yorkshire and Humber region. The WHO algorithm, PRIEST, NEWS2, and PMEWS tools all had high sensitivity for detecting COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

Ventura¹,

Denton²,

David³

et al. 2022

OAEM

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This study aimed to analyze prehospital Emergency Medical Services (EMS) response to the COVID-19 pandemic in the US through a brief systematic review of available literature in context with international prehospital counterparts. An exploration of the NCBI repository was performed using a search string of relevant keywords which returned n=5128 results; articles that met the inclusion criteria (n=77) were reviewed and analyzed in accordance with PRISMA and PROSPERO recommendations. Methodical quality was assessed using critical appraisal tools, and the Egger’s test was used for risk of bias reduction upon linear regression analysis of a funnel plot. Sources of heterogeneity as defined by P < 0.10 or I^2 > 50% were interrogated. Findings were considered within ten domains: structural/systemic; clinical outcomes; clinical assessment; treatment; special populations; dispatch/activation; education; mental health; perspectives/experiences; and transport. Findings suggest, EMS clinicians have likely made significant and unmeasured contributions to care during the pandemic via nontraditional roles, ie, COVID-19 testing and vaccine deployment. EMS plays a critical role in counteracting the COVID-19 pandemic in addition to the worsening opioid epidemic, both of which disproportionately impact patients of color. As such, being uniquely influential on clinical outcomes, these providers may benefit from standardized education on care and access disparities such as racial identity. Access to distance learning continuing education opportunities may increase rates of provider recertification. Additionally, there is a high prevalence of vaccine hesitancy among surveyed nationally registered EMS providers. Continued rigorous investigation on the impact of COVID-19 on EMS systems and personnel is warranted to ensure informed preparation for future pandemic and infectious disease responses.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

Ventura¹,

Denton²,

David³

et al. 2022

OAEM

View full text Add to dashboard Cite

show abstract

“…This is consistent with international prehospital consensus that suspicion of COVID-19 based solely on symptomatology should not be solely relied on for contemplating precautionary measures and isolation procedures. In a prehospital study in Denmark, patients under 60 years old were more likely to present with a loss of taste and/or smell upon assessment, however fever and cough were equally distributed across all age groups (49) . In England, Marincowitz et.…”

Section: Discussionmentioning

confidence: 99%

EMS prehospital response to the COVID-19 pandemic in the US: A brief literature review

Ventura

Denton

David

et al. 2022

Preprint

View full text Add to dashboard Cite

This study aimed to analyze prehospital Emergency Medical Services (EMS) response to the COVID-19 pandemic in the US through a brief systematic review of available literature in context with international prehospital counterparts. An exploration of the NCBI repository was performed using a search string of relevant keywords which returned n=5128 results; articles that met the inclusion criteria (n=77) were reviewed and analyzed in accordance with PRISMA and PROSPERO recommendations. Methodical quality was assessed using critical appraisal tools, and the Eggers test was used for risk of bias reduction upon linear regression analysis of a funnel plot. Sources of heterogeneity as defined by P < 0.10 or I^2 > 50% were interrogated. Findings were considered within ten domains: structural/systemic; clinical outcomes; clinical assessment; treatment; special populations; dispatch/activation; education; mental health; perspectives/experiences; and transport. Findings suggest, EMS clinicians have likely made significant and unmeasured contributions to care during the pandemic via nontraditional roles, i.e., COVID-19 testing and vaccine deployment. EMS plays a critical role in counteracting the COVID-19 pandemic in addition to the worsening opioid epidemic, both of which disproportionately impact patients of color. As such, being uniquely influential on clinical outcomes, these providers may benefit from standardized education on care and access disparities such as racial identity. Access to distance learning continuing education opportunities may increase rates of provider recertification. Additionally, there is a high prevalence of vaccine hesitancy among surveyed nationally registered EMS providers. Continued rigorous investigation on the impact of COVID-19 on EMS systems and personnel is warranted to ensure informed preparation for future pandemic and infectious disease response.

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“…Most studies collected data regarding GD via questionnaires or structured interviews, except for 3 studies which utilised gustatory testing [139][140][141]. Among the 44 included studies, 7 studies [142][143][144][145][146][147][148] did not test for GD or state that GD symptoms were explicitly asked for.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Alizadehsani [142] Altman [143] Beltrán-Corbellini [176] Bénézit [34] Bidkar [139] Boudjema [140] Carignan [177] Chas [144] Chen [149] Cho [178] Dawson [179] Dixon [180] Dreyer [150] Elimian [181] Fistera [145] Ganz-Lord [146] Gibbons [151] Gurrola [182] Izquierdo-Domínguez [183] Jeyashree (1) [141] Jeyashree (2) [141] Karni [152] Kempker [184] La Torre [185] Leal [186] Lee [187] Martin-Sanz [188] Martinez-Fierro [189] Moeller [147] Moolla [190] Nakanishi [191] Pérula de Torres [192] Raberahona [148] Riestra-Ayora [193] Rojas-Lechuga [194] Sayin [195] Sbrana [153] Sonoda [196] Trachootham [197] Trubiano [198] Tudrej [199] Villerabel [200] Yan [201] Zayet (1) [202] Zayet (2) [203] Appendix D Specify the methods ...…”

Section: Conflicts Of Interestmentioning

confidence: 99%

Exploring the Clinical Utility of Gustatory Dysfunction (GD) as a Triage Symptom Prior to Reverse Transcription Polymerase Chain Reaction (RT-PCR) in the Diagnosis of COVID-19: A Meta-Analysis and Systematic Review

Pang

Tham

2021

Life

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Background: The diagnosis of COVID-19 is made using reverse transcription polymerase chain reaction (RT-PCR) but its sensitivity varies from 20 to 100%. The presence of gustatory dysfunction (GD) in a patient with upper respiratory tract symptoms might increase the clinical suspicion of COVID-19. Aims: To perform a systematic review and meta-analysis to determine the pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR−) and diagnostic odds ratio (DOR) of using GD as a triage symptom prior to RT-PCR. Methods: PubMed and Embase were searched up to 20 June 2021. Studies published in English were included if they compared the frequency of GD in COVID-19 adult patients (proven by RT-PCR) to COVID-19 negative controls in case control or cross-sectional studies. The Newcastle-Ottawa scale was used to assess the methodological quality of the included studies. Results: 21,272 COVID-19 patients and 52,298 COVID-19 negative patients were included across 44 studies from 21 countries. All studies were of moderate to high risk of bias. Patients with GD were more likely to test positive for COVID-19: DOR 6.39 (4.86–8.40), LR+ 3.84 (3.04–4.84), LR− 0.67 (0.64–0.70), pooled sensitivity 0.37 (0.29–0.47) and pooled specificity 0.92 (0.89–0.94). While history/questionnaire-based assessments were predictive of RT-PCR positivity (DOR 6.62 (4.95–8.85)), gustatory testing was not (DOR 3.53 (0.98–12.7)). There was significant heterogeneity among the 44 studies (I2 = 92%, p < 0.01). Conclusions: GD is useful as a symptom to determine if a patient should undergo further testing, especially in resource-poor regions where COVID-19 testing is scarce. Patients with GD may be advised to quarantine while repeated testing is performed if the initial RT-PCR is negative. Funding: None.

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Symptom presentation of SARS-CoV-2-positive and negative patients: a nested case–control study among patients calling the emergency medical service and medical helpline

Cited by 12 publications

References 12 publications

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

EMS prehospital response to the COVID-19 pandemic in the US: A brief literature review

Exploring the Clinical Utility of Gustatory Dysfunction (GD) as a Triage Symptom Prior to Reverse Transcription Polymerase Chain Reaction (RT-PCR) in the Diagnosis of COVID-19: A Meta-Analysis and Systematic Review

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