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
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Original Investigation

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

Gazi Med J 2021;32(4):541-546 DOI: 10.12996/gmj.2021.122
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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.

Keywords: COVID-19 diagnosis, signs and symptoms, emergency service