Elsevier

Travel Medicine and Infectious Disease

Volume 38, November–December 2020, 101909
Travel Medicine and Infectious Disease

Original article
Self-reported symptoms from exposure to Covid-19 provide support to clinical diagnosis, triage and prognosis: An exploratory analysis

https://doi.org/10.1016/j.tmaid.2020.101909Get rights and content
Under a Creative Commons license
open access

Highlights

  • The triad of anosmia, ageusia and fever best distinguished those who tested positive from those who tested negative.

  • Race nor use of medications for autoimmune disorders showed meaningful increase in risk of moderate or severe dyspnea.

  • Moderate-to-severe dyspnea in the community was increased in those with obesity or underlying respiratory disorders.

Abstract

Background

Symptomatic COVID-19 is prevalent in the community. We identify factors indicating COVID-19 positivity in non-hospitalized patients and prognosticators of moderate-to-severe disease.

Methods

Appeals conducted in April–June 2020 in social media, collaborating medical societies and patient advocacy groups recruited 20,476 participants ≥18 years who believed they had COVID-19 exposure. Volunteers consented on-line and reported height, weight, concomitant illnesses, medication and supplement use, residential, occupational or community COVID-19 exposure, symptoms and symptom severity on a 4-point scale. Of the 12,117 curated analytic population 2279 reported a COVID-19 viral test result: 865 positive (COVID+) and 1414 negative (COVID-).

Results

The triad of anosmia, ageusia and fever best distinguished COVID+ from COVID-participants (OR 6.07, 95% CI: 4.39 to 8.47). COVID + subjects with BMI≥30, concomitant respiratory disorders or an organ transplant had increased risk of moderate-to- severe dyspnoea. Race and anti-autoimmunity medication did not affect moderate-to-severe dyspnea risk.

Conclusions

The triad of anosmia, ageusia and fever differentiates COVID-19. Elevated risks of severe symptoms outside the hospital were most evident among the obese and those with pulmonary comorbidity. Race and use of medication for autoimmune disease did not predict severe disease. These findings should facilitate rapid COVID-19 diagnosis and triage in settings without testing.

Keywords

Infectious disease
Epidemiology
COVID-19
Direct to patient
Anosmia
Ageusia

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