Covid-19 in outpatients—Is fever a useful indicator for SARS-CoV-2 infection?

Abstract

Objective Understanding mild to moderate symptoms of coronavirus disease 2019 (Covid-19) is important in order to identify active cases early and thus counteract transmission. Methods In March 2020, Leipzig University Hospital established an outpatient clinic for patients potentially infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Confirmed cases with mild to moderate symptoms self-isolated at home and were followed-up by daily telephone calls for at least 14 days. Symptoms and course of illness of these patients are reported here. Results From March 20 to April 17, 2020, 1460 individuals were tested for SARS-CoV-2 by naso- or oropharyngeal swab for real-time polymerase chain reaction (RT-PCR). Covid-19 was confirmed in 91 (6.2%) patients, of which 87 were included in the final analysis. Patients presented for testing after a mean of 5.9 days (IQR = 2.0–8.5). The median age was 37.0 years (IQR = 28.5–53), and 48 (55.2%) were female. Five (5.7%) patients required hospital admission during the course of illness. Most frequently reported symptoms were fatigue (n = 64, 74%), cough (n = 58, 67%), and hyposmia/hypogeusia (n = 44, 51%). In contrast to previous reports, fever occurred in less than a third of patients (n = 25, 29%). By day 14, more than half of the patients had recovered completely (n = 37/70, 52.9%). Conclusions Fever seems to be less common in patients of relatively young age diagnosed with mild to moderate Covid-19. This suggests that body temperature alone may be an insufficient indicator of SARS-CoV-2 infection.

Home Monitoring for Fever: An Inexpensive Screening Method to Prevent Household Spread of COVID-19

“…It should be emphasized that a single temperature measurement proved to be an insensitive screening tool only detecting fever in 30.3% of COVD-19 positive patients, a percentage comparable to that found in a large primary care clinic study that used a single temperature measurement (29%). 9 There are several limitations to our findings. First, we analyzed a convenience sample that may not be applicable to all socioeconomic groups and these data cannot infer cause-effect due to selection bias factors; however, the survey did include a broad geographic distribution, a wide age range and a prolonged home monitoring period.…”

“…One outpatient study measured a single body temperature on arrival to the clinic and detected fever (defined as temp of > 38°C) in only 29% of cases. 9 There are several explanations for the marked variation in the prevalence of fever. First studies were conducted in different settings with different age groups.…”

Multimodal Detection of COVID-19 Symptoms using Deep Learning & Probability-based Weighting of Modes

“…Despite the fact that fever is the most common symptoms of COVID-19 [20], a unimodal temperature measurement is not sufficient to determine whether a person is infected by the virus, as fever alone is a very common symptom of many illnesses [43]. Furthermore, fever can be less common in younger age groups that have been diagnosed with mild or moderate COVID [44]. As a result, temperature can only be utilized in combination with other modes (symptoms) in multimodal analysis.…”

Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic

“…COVID-19-like symptoms included fever, cough, sore throat, rhinorrhea, myalgia, and arthritis. Fever was defined as a tympanic temperature of at least 38°C (100.4°F) [ 11 ]. All patients were tested for COVID-19.…”