Department of Internal Medicine, Singapore General Hospital, Singapore.
Department of Infectious Diseases, Singapore General Hospital, Singapore.
J Med Virol. 2021 Mar;93(3):1548-1555. doi: 10.1002/jmv.26486. Epub 2020 Sep 29.
During this coronavirus disease 2019 (COVID-19) pandemic, physicians have the important task of risk stratifying patients who present with acute respiratory illnesses. Clinical presentation of COVID-19, however, can be difficult to distinguish from other respiratory viral infections. Thus, identifying clinical features that are strongly associated with COVID-19 in comparison to other respiratory viruses can aid risk stratification and testing prioritization especially in situations where resources for virological testing and resources for isolation facilities are limited. In our retrospective cohort study comparing the clinical presentation of COVID-19 and other respiratory viral infections, we found that anosmia and dysgeusia were symptoms independently associated with COVID-19 and can be important differentiating symptoms in patients presenting with acute respiratory illness. On the other hand, laboratory abnormalities and radiological findings were not statistically different between the two groups. In comparing outcomes, patients with COVID-19 were more likely to need high dependency or intensive care unit care and had a longer median length of stay. With our findings, we emphasize that epidemiological risk factors and clinical symptoms are more useful than laboratory and radiological abnormalities in differentiating COVID-19 from other respiratory viral infections.
在当前 2019 冠状病毒病(COVID-19)大流行期间,医生有重要的任务,要对出现急性呼吸道疾病的患者进行风险分层。然而,COVID-19 的临床表现可能难以与其他呼吸道病毒感染区分。因此,与其他呼吸道病毒相比,确定与 COVID-19 强烈相关的临床特征有助于风险分层和检测优先级,特别是在病毒学检测资源和隔离设施资源有限的情况下。在我们比较 COVID-19 和其他呼吸道病毒感染临床表现的回顾性队列研究中,我们发现嗅觉丧失和味觉障碍是与 COVID-19 独立相关的症状,并且是急性呼吸道疾病患者的重要鉴别症状。另一方面,两组之间的实验室异常和影像学发现无统计学差异。在比较结果时,COVID-19 患者更有可能需要高度依赖或重症监护病房护理,且中位住院时间更长。根据我们的发现,我们强调,在区分 COVID-19 与其他呼吸道病毒感染时,流行病学危险因素和临床症状比实验室和影像学异常更有用。