Study Objectives: With COVID-19 cases increasing nationally, there is demand for policies that can slow the spread of the virus As businesses and health services begin to relax restrictions, there are increased efforts to identify individuals who are most likely to have contracted the virus based on symptomology One commonly employed screening method has been body temperature checks prior to being allowed entry to an establishment The objective of this study was to assess both measured and self-reported body temperature among Emergency Department (ED) patients tested for COVID-19 Methods: We conducted a multi-center, retrospective study among patients presenting to two EDs with a combined annual census of ∼80,000 (an urban level 1 trauma center and a suburban academic hospital) The study period included all ED encounters between March 10, 2020 (start of testing for COVID-19 in the ED) and May 25, 2020 We compared fever based on patient body temperature of &gt;=100 4 degrees Fahrenheit (measured in the ED) as well as subjective fever/chills complaints among patients with a positive COVID-19 test result (n=235), a negative COVID-19 test result (n=4412), and no COVID-19 testing performed (n=8179) Odds ratios (OR) and 95% Confidence Intervals (CI) are presented for comparisons between patients with a positive and negative test result Results: Overall, 26 5% (n=62) of patients who tested positive for COVID-19 presented with a recorded temperature of 100 4 degrees Fahrenheit or greater, compared to 7 5% of (n=334) of patients who tested negative (OR=0 89;95% CI=2 86-5 30) For reference, 1 1% (n=91) of patients in which a COVID-19 test was not performed had a recorded temperature &gt;=100 4 degrees Among patients who tested positive for COVID-19, 59 6% (n=140) presented with a subjective fever and/or chills, compared to 26 8% (n=1187) of patients who tested negative (OR=4 03, 95% CI=3 08-5 28) For reference, 6 1% (n=505) of patients without COVID-19 testing reported subjective fever and/or chills Among patients who tested positive for COVID-19, elderly patients &gt;=65 years of age were just as likely to have a recorded fever (OR=0 72, 95% CI=0 38-1 37) and self-reported fever (OR=0 80, 95% CI= 46-1 38) as patients under the age of 65 years;although, among patients who tested negative for COVID-19, elderly patients were less likely to report a subjective fever (OR=0 58, 95% CI= 0 49-0 68) Conclusion: In this study of ED patients tested for COVID-19, we find that patients with a positive test result are more likely to have both a recorded and subjective fever Further, nearly three quarters of the patients who tested positive were not identified as having a recorded fever of at least 100 4 degrees at presentation Given this result, and the similarity between recorded and self-reported fevers in this study, self-report questions used in tandem with temperature checks should be explored for screening individuals prior to entry into general patient areas, as well as other businesses and facilities that rely on temperature screening for admittance
171 COVID-19 Symptoms among Emergency Department Patients and Implications for Screening