Clinical features of covid-19 patients: is temperature screening useful?

Vilke, Gary M.; Brennan, Jesse J.; Cronin, Alexandrea O.; Castillo, Edward M.

Background As many businesses reopen following government-induced restrictions, many public agencies and private companies, such as banks, golf courses and stores, are using temperature screening to assess for possible COVID-19 infection for patrons and employees. Study Objective To assess the frequency of a fever of 100.4°F or higher and other symptoms associated with COVID-19 among Emergency Department (ED) patients who are tested in the ED for the illness. Methods This is a retrospective review of data from patients who were tested for acute COVID-19 infection from March 10, 2020 through June 30, 2020 at two EDs within the same health system. Data collected included temperature, the presence or recent history of COVID-19 related symptoms and COVID-19 test results. Descriptive statistics are reported for presenting fever and other COVID-19 related symptoms alone and in combination with presenting fever. Results A total of 6,894 patients were tested for COVID-19 infection. Among these, 330 (4.8%) tested positive for active infection. Of these patients, 664 (19.4%) presented with a fever of at least 100.4ºF (38.0ºC). Increasing the number of COVID-19-related symptoms in combination with a presenting fever of at least 100.4°F increased the number of people who could be identified as having COVID-19 infection. Conclusion About a quarter of patients who were tested positive for COVID-19 in our ED do not have a fever at presentation greater than or equal to 100.4°F. Using temperature only to screen for COVID-19 in the community setting will likely miss the majority of patients with active disease.