key: cord-1000064-g7kbmsrr
authors: Mitra, Biswadev; Luckhoff, Carl; Mitchell, Rob D; O'Reilly, Gerard; Smit, De Villiers; Cameron, Peter A.
title: Temperature screening has negligible value for control of COVID‐19
date: 2020-06-24
journal: Emerg Med Australas
DOI: 10.1111/1742-6723.13578
sha: 0033f75e40e88ad6a07acee9b4673aa9c4e3dc4f
doc_id: 1000064
cord_uid: g7kbmsrr

OBJECTIVE: To report the incidence of fever among patients who tested positive for SARS‐CoV‐2. METHODS: Retrospective cohort study of patients who tested positive for SARS‐Cov‐2 at a single centre. Temperature at time of testing and on repeat testing within 24 h were collected. RESULTS: At the time of testing, fever was detected (sensitivity) in 16 of 86 (19%; 95% CI: 11–28) episodes of positive tests for SARS‐CoV‐2. With repeat testing, fever was detected in 18 of 75 (24%; 95% CI: 15–35) episodes. CONCLUSIONS: In an Australian hospital, screening for fever lacked sensitivity for detection of people with SARS‐CoV‐2. This article is protected by copyright. All rights reserved.

Participants: All patients that underwent testing for SARS-CoV-2 from 09 March 2020 to 13 May 2020 were eligible for inclusion. Patients presenting for screening of COVID-19 only were excluded as temperatures were not recorded. Episodes of repeat testing within a 24-hour period were excluded.

Design: This was a retrospective cohort study including all patients that presented to hospital and returned a positive test for SARS-CoV-2. The primary outcome was sensitivity of fever for a positive SARS-Cov-2 test result. Testing of nose and throat swab samples was performed using quantitative reverse-transcription polymerase chain reaction. 6 Data were extracted for the outcome variables of body temperature at the time of testing (or closest available recording) and when repeated, the highest temperature within the next 24 hours.

Age, sex and mode of temperature measurement were also extracted. Based on Australian Government guidelines, fever was defined as a body temperature of ≥38°C. 7

Analysis: Results were reported using proportions with 95% confidence intervals. All analyses were conducted using Stata v 15 (College Station, TX, USA). This study was performed as part the COVED registry that was approved by The Alfred Hospital Research and Ethics Committee. 8 

There were 86 tests on 34 patients retained for analysis, of which 75 tests were repeated ( Figure 1 ). Included patients were aged 55 (SD 15) years and 25 (73.5%) were of male sex.

The primary indication (available for 68 episodes) was pneumonia (24; 35%), case contact (15; 22%), being in a moderate or high risk setting (16; 24%), symptoms (8; 12%), overseas travel (4; 6%) and advanced age (1; 1%). Most measurements were performed using temporal thermometers (53; 62%); 14 (16%) were measured from the bladder, 5 (6%) from the ear canal, 4 (5%) oral, 4 (5%) nasopharyngeal, 4(5%) axillary and mode of measurement was not recorded for 2 episodes. Fever at the time of testing (sensitivity) was detected in 16 (19%; 95%CI: 11-28) episodes, while fever on repeat testing within 24h was detected in 18 (24%; 95%CI: 15-35) episodes ( Figure 2 ).

This article is protected by copyright. All rights reserved.

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