For a person accessing primary care, how can I decide which symptoms are more likely to suggest a current COVID-19 infection in order to decide further which of them should be tested in preparation for a face to face consultation?
What the research says:
We reviewed multiple research databases to determine which symptoms are strong indicators for current COVID-19 infection. The research says that a persistent high temperature (>39oC), a constant cough and a loss of smell or taste are strong indicators for current COVID-19 infection. Additional symptoms that are suggestive of a current COVID-19 infection are shown in the figure below.
What this means for your clinical practice:
COVID-19 should be considered for a patient with the symptoms described in the figure above because they indicate a higher probability of current infection. Local guidelines should be consulted for determining the number and relative importance of symptoms required to indicate infection.
Where possible triage patients remotely, for example by telephone, prior to face to face consultations in primary care. All patients, including those attending for face to face consultation, should be asked to declare any symptoms that might suggest current COVID-19 infection.
Supporting references and databases
COVID Symptom Study. Available at: https://covid.joinzoe.com/us-post/covid-clusters. Accessed January 2021.
Spencer E, et al. When is Covid, Covid ? September 2020. Available at: https://www.cebm.net/covid-19/when-is-covid-covid/. Accessed January 2021.
Sudre CH, et al. Symptom clusters in COVID19: A potential clinical prediction tool from the COVID Symptom study app. Available at: https://www.medrxiv.org/content/10.1101/2020.06.12.20129056v1. Accessed January 2021.
WHO. WHO COVID-19: Case Definitions. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-Surveillance_Case_... . Accessed January 2021