Clinical Recommendation for Emergency Physicians to Approach to Signs and Symptoms Related to COVID-19; a Preliminary Study

Abstract

Introduction: There is not enough and comprehensive evidence on signs and symptoms of COVID-19; therefore, it seems too early to provide an appropriate clinical decision-making rule for this newly emerged pandemic viral disease. Objective: We tried to categorize patients’ signs and symptoms from very highly suspected to non-suspected, regarding having COVID-19. Methods: Most recently published English-language articles on COVID-19, were reviewed by the researchers. We considered each complaint, separately, and gathered available data, such as percentage of involved patients and their crude number. Then we considered the pooled and collected results as the final percentage of the occurrence of every specific symptom. We categorized patients’ complaints into six types, based on the data obtained. All extracted complaints were categorized and scored. Results: Twenty-seven articles were reviewed, of which, 12 considered for analysis. The selected papers had reported various numbers of patients, ranging from 16 to 1,099 patients (mean=229 patients per study). In total, nineteen different complaints, with an average of nine complaints per article, had been reported (IQR= 8-11). In terms of overall prevalence, based on the total number of patients, fever and dry cough were reported in more than half of the referred patients. The complaints were categorized in six types with and scored. Conclusions: The patients with score ≥17 are very highly suspected to COVID-19; However, patients with score <5 could be considered as non-suspected to COVID-19.