Is the presence of a typical triad of COVID-19 symptoms (cough, dyspnea, and fever) enough to make a decision about diagnostic testing? From the perspective of an emergency department Is the typical triad symptoms enough for COVID-19

Main Article Content

Ayfer Keleş
Bahar Alkaş
İsa Kılıçaslan
Mehmet Ali Aslaner
Fikret Bildik
Ahmet Demircan
Asiye Uğraş Dikmen
Hasan Selçuk Özger
Gülendam Bozdayı
Hüseyin Koray Kılıç
Busegül Karakök
Merve Türker

Abstract

Objective: The aim of this study is to show the consistence between the recommended guidelines regarding the triad of symptoms—cough, dyspnea, and fever—and the diagnosis of COVID-19.


Methods: A prospective observational study conducted at a tertiary emergency department between April 2, 2020 and May 15, 2020 in Turkey. Detailed patient history, main presenting complaints and imaging findings were recorded. For COVID-19 confirmation, nasopharyngeal RT-PCR was used. The relationship between complaints and COVID-19 test results were analyzed.


Results: Of the 1226, suspected COVID-19 patients, 127 were positive, 471 were negative, and 628 were discharged without any tests. The most common presenting complaints of the COVID-19 positive patients were throat pain (25.2%), dyspnea (15%), cough (22%), malaise and fatigue (11.8%), and fever (8.7%). There was no statistically significant difference between the positive and negative test groups as they had fever (χ2, p = 0.30), cough (χ2, p = 0.67) and dyspnea (χ2, p = 0.14).


Conclusion: Considering that it is difficult to diagnose COVID-19 in emergency settings, testing decision and diagnosis should not depend only on classical symptoms; otherwise, patients with atypical and rare symptoms may be missed. Instead, patient history, clinical status, and radiological findings should be considered together.

Article Details

Section
Original Research