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Characteristics associated with COVID-19 or other respiratory viruses' infections at a single-center Emergency Department
  • +11
  • Donia BOUZID,
  • Jimmy Mullaert,
  • Quentin Le hingrat,
  • odile Laurent,
  • Xavier Duval,
  • Xavier Lescure,
  • Jean François Timsit,
  • Diane Descamps,
  • Philippe Montravers,
  • Christophe Choquet,
  • ED influenza management study group,
  • Jean Christophe Lucet,
  • Enrique Casalino,
  • Benoit Visseaux
Donia BOUZID
APHP
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Jimmy Mullaert
APHP
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Quentin Le hingrat
APHP
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odile Laurent
APHP
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Xavier Duval
Universite Paris Diderot
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Xavier Lescure
APHP
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Jean François Timsit
APHP
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Diane Descamps
APHP
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Philippe Montravers
APHP
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Christophe Choquet
APHP
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ED influenza management study group
APHP
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Jean Christophe Lucet
APHP
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Enrique Casalino
APHP
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Benoit Visseaux
APHP
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Abstract

Background Rapid identification of patients with high suspicion of COVID-19 may become a challenge with the co-circulation of multiple respiratory viruses (RVs). We have identified clinical or biological characteristics to help distinguish SARS-CoV-2 from other RVs. Methods We used a prospective cohort including all consecutive patients admitted through the emergency department’s (ED) and presenting respiratory symptoms from November 2019 to April 2020. Patients were tested for RV using multiplex polymerase chain reaction (mPCR) and SARS-CoV-2 RT-PCR. Results 203/508 patients were positive for an RV during the non-SARS-CoV-2 epidemic period (November to February), and 268/596 patients were SARS-CoV-2 positive during the SARS-CoV-2 epidemic (March to April). Younger age, male gender, fever, absence of expectoration and absence of chronic lung disease were statistically associated with SARS-CoV-2 detection. Combining these variables allowed for the distinguishing of SARS-CoV-2 infections with 83, 65, 75 and 76% sensitivity, specificity, PPV and NPV, respectively. Conclusion Patients’ characteristics associated with a positive PCR are common between SARS-CoV-2 and other RVs, but a simple discrimination of strong SARS-CoV-2 suspicion with a limited set of clinical features seems possible. Such scoring could be useful but has to be prospectively evaluated and will not eliminate the need for rapid PCR assays.