Diagnostic Accuracy and Predictive Value of Clinical Symptoms for the Diagnosis of Mild COVID-19

Vasyl Popovych,Yulia Haman,Ruslan Duplikhin,Ivana Koshel,Vitaly Leschak

doi:10.4236/jbm.2021.96013

Abstract

Objective: To assess the diagnostic accuracy and predictive values of clinical symptoms in patients with suspected mild COVID-19 to identify target groups for self-isolation and outpatient treatment without additional testing. Methods: We conducted an open-label prospective study in patients aged 18 to 72 years with suspected mild COVID-19. The clinical diagnosis was based on the acute onset of such symptoms as olfactory dysfunction, hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia, sore throat, without pneumonia in persons in contact with a confirmed case of COVID-19. The physician assessed clinical symptoms using a 4-point scale. The patient self-assessed clinical symptoms using a ten-point visual analogue scale (VAS). All enrolled patients underwent laboratory testing to confirm the diagnosis of COVID-19. Results: Of the 120 patients underwent testing, the diagnosis of mild COVID-19 was confirmed in 96 patients and ruled out in 24 patients. When assessing symptoms by a physician according to the correlation analysis, hyperthermia, myalgia, nasal congestion and rhinolalia have a positive predictive value with a significance level of more than 0.6. When self-assessing symptoms by a patient, fever, myalgia and nasal congestion have a diagnostic accuracy with a significance level of more than 0.5. Nasal discharge, cough and sore throat have negative predictive values. Conclusion: The presence of these symptoms in patients with an acute onset of the disease can help to make a clinical diagnosis of coronavirus disease and identify target groups for self-isolation and outpatient treatment without additional testing. Highly suspect asymptomatic patients are not considered as those who have possible mild COVID-19 infection.

Highlights

The novel 2019-nCoV coronavirus is of great concern since the virus is rapidly spreading around the world and the number of cases and deaths continues to rise
The clinical diagnosis was based on the acute onset of such symptoms as olfactory dysfunction, hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia, sore throat, without pneumonia in persons in contact with a confirmed case of COVID-19
Symptoms which met the diagnostic criteria for mild COVID-19 were used as indexes: hyperthermia, myalgia, nasal congestion, nasal discharge, cough, rhinolalia and sore throat

Summary

Introduction

The novel 2019-nCoV coronavirus is of great concern since the virus is rapidly spreading around the world and the number of cases and deaths continues to rise. In its updated strategies to prevent the spread of COVID-19, WHO expresses the need for diagnosis and effective treatment of patients with a mild and moderate disease [11]. Mild COVID-19 is characterized by well-known non-specific manifestations: fever, cough, sore throat, nasal congestion, malaise, headache and muscle pain [12] These symptoms are typical for non-severe acute viral upper respiratory tract infections, in particular acute nasopharyngitis, caused by already known human coronaviruses, in particular hCoV-229E, OC43, NL63 and HKU1 [13]. Under present circumstances of the total spread of the pandemic and still limited testing capacity, there are no clear criteria to make a clinical diagnosis of mild COVID-19 and to identify individuals for self-isolation and outpatient treatment

Methods

Results

Conclusion