CLINICAL FEATURES OF PATIENTS WITH COVID-19: IS TEMPERATURE SCREENING USEFUL?

Background: As many businesses reopen after government-induced restrictions, many public agencies and private companies, such as banks, golf courses, and stores, are using temperature screening to assess for possible coronavirus disease 2019 (COVID-19) infection both for patrons and for employees. Objective: We assessed the frequency of a fever >= 100.4 degrees F and other symptoms associated with COVID-19 among patients in the emergency department (ED) who were 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 care 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 6894 patients were tested for COVID-19. Among these, 330 (4.8%) tested positive for active infection. Of these patients, 64 (19.4%) presented with a fever >= 100.4 degrees F (>= 38.0 degrees C). Increasing the number of COVID-19-related symptoms in combination with a presenting fever >= 100.4 degrees F increased the number of people who could be identified as having a COVID-19 infection. Conclusions: About a quarter of patients who were tested positive for COVID-19 in our ED did not have a fever at presentation >= 100.4 degrees F. Using only temperature to screen for COVID-19 in the community setting will likely miss the majority of patients with active disease. (C) 2020 Elsevier Inc. All rights reserved.