Objective: Coronavirus disease 2019 (COVID-19) has spread worldwide, including Japan. However, little is known about the clinical symptoms which discriminate between COVID-19 and non-COVID-19 among outpatients in general practitioner clinics, which is important for efficient case detection. The aim of this study was to investigate the clinical symptoms to discriminate between COVID-19 and non-COVID-19 cases among outpatients in general practitioner clinics during the second wave of the COVID-19 pandemic in Japan in August 2020. Methods: The records of 360 patients who visited a clinic with suspicion of infectious disease and underwent COVID-19 PCR test between 1 and 14 August 2020 were used. The patients filled out a questionnaire on possible clinical symptoms and transmission routes. Multivariate logistic regression was used to investigate the association between clinical symptoms and COVID-19 status. Results: COVID-19-positive patients were 17 (4.7%). Multiple logistic regression analyses showed that anosmia (odds ratio (OR), 25.94 95% confidence interval (CI), 7.15–94.14; p < 0.001), headache (OR, 3.31 95% confidence interval (CI), 0.98–11.20; p = 0.054), sputum production (OR, 3.32 CI, 1.01–10.90; p = 0.048) and history of visiting an izakaya or bar (OR, 4.23 CI, 0.99–18.03; p = 0.051) were marginally significantly associated withbeing COVID-19 positive. This model showed moderate predictive power (area under receiver operating characteristic curve = 0.870 CI, 0.761 to 0.971). Conclusions: We found that anosmia, headache, sputum production, history of visiting an izakaya or bar were associated with COVID-19, which can be used to detect patients with COVID-19 in out-patient clinics in Japan. The findings of this study need to be verified in other clinics and hospitals in Japan and other countries with universal healthcare coverages.
【저자키워드】 severe acute respiratory syndrome coronavirus-2, Non-COVID-19, clinical symptom, out-patient, 【초록키워드】 COVID-19, Coronavirus disease 2019, COVID-19 pandemic, hospital, Infectious disease, headache, Anosmia, clinics, Spread, healthcare, Patient, Logistic regression, Japan, second wave, characteristic, moderate, questionnaire, association, Outpatient, Transmission routes, Analysis, Odds ratio, 95% confidence interval, multivariate, predictive power, positive, multiple logistic regression, COVID-19 PCR test, country, sputum production, was used, detect, significantly, can be used, were used, non-COVID-19 case, patients with COVID-19, with COVID-19, 【제목키워드】 clinical, Japan, score, Cold, Practitioner, common, with COVID-19,