Evidence Review: Assessment of COVID-19 in Primary Care: the Identification of Symptoms, Signs, Characteristics, Comorbidities and Clinical Signs in Adults which may Indicate a Higher Risk of Progression to Severe Disease

Abstract

The purpose of this rapid review is to provide NHSScotland with advice on assessment of patients with COVID-19 in primary care. This guidance is for: general practitioners and primary care teams involved in the assessment of patients presenting with potential COVID-19. Since the outbreak of coronavirus, there has been an abundance of rapid and systematic reviews published on the diagnosis and management of people with symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known as COVID-19, mostly from a secondary care (hospital) perspective. About 80% of people with COVID-19 have symptoms which are mild (no pneumonia manifestations) or  asymptomatic. Others develop severe disease (defined as requiring admission to an intensive care unit (ICU)). The challenge for primary care practitioners is to identify and triage patients presenting with potential COVID19, a disease in which the pattern and duration of symptoms is heterogeneous. This is compounded by the need to conduct consultations via telephone or video. In addition, the evidence-base is not robust and is subject to change as new evidence emerges. The COVID-19 Scottish Primary Care Hub Triage Guide lists the common symptoms, and
provides red flags for those requiring immediate assessment and yellow flags for those at a higher risk of deterioration (eg with certain comorbidities). We conducted a search for new evidence on prognostic indicators, risk factors and clinical measures to identify people  selfmanaging symptoms of COVID-19 in the community whose symptoms may change or worsen, and therefore may require monitoring or clinical intervention after their initial presentation to primary care. The research question and methodology can be found in section 6.

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Available under License Creative Commons Attribution Non-commercial No Derivatives

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http://eprints.gla.ac.uk/215857/