Open AccessCharacteristics associated with COVID-19 or other respiratory viruses’ infections at a single-center emergency department
Author(s) -
Donia Bouzid,
Jimmy Mullaert,
Quentin Le Hingrat,
Odile Laurent,
Xavier Duval,
Xavier Lescure,
JeanFrançois Timsit,
Diane Descamps,
Philippe Montravers,
Christophe Choquet,
JeanChristophe Lucet,
Enrique Casalino,
Benoît Visseaux,
AUTHOR_ID
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0243261
Subject(s) - medicine , emergency department , prospective cohort study , covid-19 , pneumonia , multiplex polymerase chain reaction , respiratory system , cohort study , emergency medicine , virology , disease , polymerase chain reaction , infectious disease (medical specialty) , biology , biochemistry , psychiatry , gene
Background Rapid identification of patients with high suspicion of COVID-19 will 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.