{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T08:25:42Z","timestamp":1747383942964,"version":"3.40.5"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T00:00:00Z","timestamp":1626825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The objective of this study was to identify clinical risk factors for COVID-19 in a German outpatient fever clinic that allow distinction of SARS-CoV-2 infected patients from other patients with flu-like symptoms.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a retrospective, single-centre cohort study. Patients were included visiting the fever clinic from 4<jats:sup>th<\/jats:sup> of April 2020 to 15<jats:sup>th<\/jats:sup> of May 2020. Symptoms, comorbidities, and socio-demographic factors were recorded in a standardized fashion. Multivariate logistic regression was used to identify risk factors of COVID-19, on the bases of those a model discrimination was assessed using area under the receiver operation curves (AUROC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The final analysis included 930 patients, of which 74 (8%) had COVID-19. Anosmia (OR 10.71; CI 6.07\u201318.9) and ageusia (OR 9.3; CI 5.36\u201316.12) were strongly associated with COVID-19. High-risk exposure (OR 12.20; CI 6.80\u201321.90), especially in the same household (OR 4.14; CI 1.28\u201313.33), was also correlated; the more household members, especially with flu-like symptoms, the higher the risk of COVID-19. Working in an essential workplace was also associated with COVID-19 (OR 2.35; CI 1.40\u20133.96), whereas smoking was inversely correlated (OR 0.19; CI 0.08\u20130.44). A model that considered risk factors like anosmia, ageusia, concomitant of symptomatic household members and smoking well discriminated COVID-19 patients from other patients with flu-like symptoms (AUROC 0.84).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We report a set of four readily available clinical parameters that allow the identification of high-risk individuals of COVID-19. Our study will not replace molecular testing but will help guide containment efforts while waiting for test results.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0254990","type":"journal-article","created":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T17:33:32Z","timestamp":1626888812000},"page":"e0254990","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Predictors of COVID-19 in an outpatient fever clinic"],"prefix":"10.1371","volume":"16","author":[{"given":"Frank","family":"Tr\u00fcbner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Steigert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Echterdiek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norma","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4426-9565","authenticated-orcid":true,"given":"Kirsten","family":"Schmidt-Hellerau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfram G.","family":"Zoller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia-Stefanie","family":"Frick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"You-Shan","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1075-4362","authenticated-orcid":true,"given":"Gregor","family":"Paul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,7,21]]},"reference":[{"issue":"22","key":"pone.0254990.ref001","doi-asserted-by":"crossref","first-page":"e120","DOI":"10.1056\/NEJMp2025631","article-title":"Rethinking Covid-19 Test Sensitivity\u2014A Strategy for Containment","volume":"383","author":"MJ Mina","year":"2020","journal-title":"New England Journal of Medicine"},{"issue":"10243","key":"pone.0254990.ref002","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0140-6736(20)31278-2","article-title":"Active case finding with case management: the key to tackling the COVID-19 pandemic","volume":"396","author":"Z Li","year":"2020","journal-title":"The Lancet"},{"key":"pone.0254990.ref003","doi-asserted-by":"crossref","first-page":"m1985","DOI":"10.1136\/bmj.m1985","article-title":"Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study","volume":"369","author":"AB Docherty","year":"2020","journal-title":"BMJ"},{"issue":"15","key":"pone.0254990.ref004","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1093\/cid\/ciaa322","article-title":"Epidemiological and Clinical Predictors of COVID-19","volume":"71","author":"Y Sun","year":"2020","journal-title":"Clin Infect Dis"},{"key":"pone.0254990.ref005","doi-asserted-by":"crossref","first-page":"m1328","DOI":"10.1136\/bmj.m1328","article-title":"Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal","volume":"369","author":"L Wynants","year":"2020","journal-title":"BMJ"},{"issue":"7","key":"pone.0254990.ref006","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1038\/s41591-020-0916-2","article-title":"Real-time tracking of self-reported symptoms to predict potential COVID-19","volume":"26","author":"C Menni","year":"2020","journal-title":"Nature Medicine"},{"issue":"16","key":"pone.0254990.ref007","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1093\/cid\/ciaa576","article-title":"Risk Factors for Severe Disease and Efficacy of Treatment in Patients Infected With COVID-19: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis","volume":"71","author":"JJY Zhang","year":"2020","journal-title":"Clin Infect Dis"},{"key":"pone.0254990.ref008","article-title":"The importance of anosmia, ageusia and age in community presentation of symptomatic and asymptomatic SARS-CoV-2 infection in Louisiana, USA; 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