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. 2021 Feb 19;10(4):854.
doi: 10.3390/jcm10040854.

Validity of Clinical Symptoms Score to Discriminate Patients with COVID-19 from Common Cold Out-Patients in General Practitioner Clinics in Japan

Shiro Sonoda  1 , Jin Kuramochi  1 , Yusuke Matsuyama  2 , Yasunari Miyazaki  3 , Takeo Fujiwara  2
Affiliations

Validity of Clinical Symptoms Score to Discriminate Patients with COVID-19 from Common Cold Out-Patients in General Practitioner Clinics in Japan

Shiro Sonoda et al. J Clin Med. .

Abstract

Objective: Coronavirus disease 2019 (COVID-19) has spread worldwide, including Japan. However, little is known about the clinical symptoms which discriminate between COVID-19 and non-COVID-19 among outpatients in general practitioner clinics, which is important for efficient case detection. The aim of this study was to investigate the clinical symptoms to discriminate between COVID-19 and non-COVID-19 cases among outpatients in general practitioner clinics during the second wave of the COVID-19 pandemic in Japan in August 2020.

Methods: The records of 360 patients who visited a clinic with suspicion of infectious disease and underwent COVID-19 PCR test between 1 and 14 August 2020 were used. The patients filled out a questionnaire on possible clinical symptoms and transmission routes. Multivariate logistic regression was used to investigate the association between clinical symptoms and COVID-19 status.

Results: COVID-19-positive patients were 17 (4.7%). Multiple logistic regression analyses showed that anosmia (odds ratio (OR), 25.94 95% confidence interval (CI), 7.15-94.14; p < 0.001), headache (OR, 3.31 95% confidence interval (CI), 0.98-11.20; p = 0.054), sputum production (OR, 3.32 CI, 1.01-10.90; p = 0.048) and history of visiting an izakaya or bar (OR, 4.23 CI, 0.99-18.03; p = 0.051) were marginally significantly associated withbeing COVID-19 positive. This model showed moderate predictive power (area under receiver operating characteristic curve = 0.870 CI, 0.761 to 0.971).

Conclusions: We found that anosmia, headache, sputum production, history of visiting an izakaya or bar were associated with COVID-19, which can be used to detect patients with COVID-19 in out-patient clinics in Japan. The findings of this study need to be verified in other clinics and hospitals in Japan and other countries with universal healthcare coverages.

Keywords: clinical symptom; non-COVID-19; out-patient; severe acute respiratory syndrome coronavirus-2.

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Conflict of interest statement

The authors have no conflict of interest directly relevant to the content of this article.

Figures

Figure 1
Figure 1
Receiver operating characteristic (ROC) curve in four independent cohorts.
See this image and copyright information in PMC

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