TY - JOUR

T1 - Symptom presentation of SARS-CoV-2-positive and negative patients

T2 - A nested case-control study among patients calling the emergency medical service and medical helpline

AU - Moeller, Amalie Lykkemark

AU - Mills, Elisabeth Helen Anna

AU - Collatz Christensen, Helle

AU - Gnesin, Filip

AU - Blomberg, Stig Nikolaj Fasmer Nikolaj

AU - Zylyftari, Nertila

AU - Jensen, Britta

AU - Ringgren, Kristian Bundgaard

AU - Broccia, Marcella Ditte

AU - Bøggild, Henrik

AU - Torp-Pedersen, Christian

N1 - Publisher Copyright: © 2021 Author(s). Published by BMJ.

PY - 2021/5/24

Y1 - 2021/5/24

N2 - Objective Currently effective symptom-based screening of patients suspected of COVID-19 is limited. We aimed to investigate age-related differences in symptom presentations of patients tested positive and negative for SARS-CoV-2. DesignSetting Calls to the medical helpline (1-8-1-3) and emergency number (1-1-2) in Copenhagen, Denmark. At both medical services all calls are recorded. Participants We included calls for patients who called for help/guidance at the medical helpline or emergency number prior to receiving a test for SARS-CoV-2 between April 1 st and 20 th 2020 (8423 patients). Among these calls, we randomly sampled recorded calls from 350 patients who later tested positive and 250 patients tested negative and registered symptoms described in the call. OutcomeResults After exclusions, 544 calls (312 SARS-CoV-2 positive and 232 negative) were included in the analysis. Fever and cough remained the two most common of COVID-19 symptoms across all age groups and approximately 42% of SARS-CoV-2 positive and 20% of negative presented with both fever and cough. Symptoms including nasal congestion, irritation/pain in throat, muscle/joint pain, loss of taste and smell, and headache were common symptoms of COVID-19 for patients younger than 60 years; whereas loss of appetite and feeling unwell were more commonly seen among patients over 60 years. Headache and loss of taste and smell were rare symptoms of COVID-19 among patients over 60 years. Conclusion Our study identified age-related differences in symptom presentations of SARS-CoV-2-positive patients calling for help or medical advice. The specific symptoms of loss of smell or taste almost exclusively reported by patients younger than 60 years. Differences in symptom presentation across age groups must be considered when screening for COVID-19.

AB - Objective Currently effective symptom-based screening of patients suspected of COVID-19 is limited. We aimed to investigate age-related differences in symptom presentations of patients tested positive and negative for SARS-CoV-2. DesignSetting Calls to the medical helpline (1-8-1-3) and emergency number (1-1-2) in Copenhagen, Denmark. At both medical services all calls are recorded. Participants We included calls for patients who called for help/guidance at the medical helpline or emergency number prior to receiving a test for SARS-CoV-2 between April 1 st and 20 th 2020 (8423 patients). Among these calls, we randomly sampled recorded calls from 350 patients who later tested positive and 250 patients tested negative and registered symptoms described in the call. OutcomeResults After exclusions, 544 calls (312 SARS-CoV-2 positive and 232 negative) were included in the analysis. Fever and cough remained the two most common of COVID-19 symptoms across all age groups and approximately 42% of SARS-CoV-2 positive and 20% of negative presented with both fever and cough. Symptoms including nasal congestion, irritation/pain in throat, muscle/joint pain, loss of taste and smell, and headache were common symptoms of COVID-19 for patients younger than 60 years; whereas loss of appetite and feeling unwell were more commonly seen among patients over 60 years. Headache and loss of taste and smell were rare symptoms of COVID-19 among patients over 60 years. Conclusion Our study identified age-related differences in symptom presentations of SARS-CoV-2-positive patients calling for help or medical advice. The specific symptoms of loss of smell or taste almost exclusively reported by patients younger than 60 years. Differences in symptom presentation across age groups must be considered when screening for COVID-19.

KW - COVID-19

KW - epidemiology

KW - telemedicine

U2 - 10.1136/bmjopen-2020-044208

DO - 10.1136/bmjopen-2020-044208

M3 - Journal article

C2 - 34031110

AN - SCOPUS:85106930954

VL - 11

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 5

M1 - e044208

ER -