Characteristics associated with COVID-19 or other respiratory viruses'
infections at a single-center Emergency Department
Background Rapid identification of patients with high suspicion of
COVID-19 may 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.