{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:50:04Z","timestamp":1760233804728,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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\u201394.14; p &lt; 0.001), headache (OR, 3.31 95% confidence interval (CI), 0.98\u201311.20; p = 0.054), sputum production (OR, 3.32 CI, 1.01\u201310.90; p = 0.048) and history of visiting an izakaya or bar (OR, 4.23 CI, 0.99\u201318.03; 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.<\/jats:p>","DOI":"10.3390\/jcm10040854","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T09:06:10Z","timestamp":1613725570000},"page":"854","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Validity of Clinical Symptoms Score to Discriminate Patients with COVID-19 from Common Cold Out-Patients in General Practitioner Clinics in Japan"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9184-5679","authenticated-orcid":false,"given":"Shiro","family":"Sonoda","sequence":"first","affiliation":[{"name":"Kuramochi Clinic Interpark, Utsunomiya, Tochigi 321-0114, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Kuramochi","sequence":"additional","affiliation":[{"name":"Kuramochi Clinic Interpark, Utsunomiya, Tochigi 321-0114, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9073-9815","authenticated-orcid":false,"given":"Yasunari","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1074-3954","authenticated-orcid":false,"given":"Takeo","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/joim.13091","article-title":"COVID-19 diagnosis and management: A comprehensive review","volume":"288","author":"Pascarella","year":"2020","journal-title":"J. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study","volume":"395","author":"Chen","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Angelidi, A.M., Belanger, M.J., Lorinsky, M.K., Karamanis, D., Chamorro-Pareja, N., Ognibene, J., Palaiodimos, L., and Mantzoros, C.S. (2021). Vitamin D Status is Associated with In-hospital Mortality and Mechanical Ventilation: A Cohort of COVID-19 Hospitalized Patients. Mayo Clin. Proc., in press.","DOI":"10.1016\/j.mayocp.2021.01.001"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"154262","DOI":"10.1016\/j.metabol.2020.154262","article-title":"Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York","volume":"108","author":"Palaiodimos","year":"2020","journal-title":"Metabolism"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s00405-020-06120-6","article-title":"Olfactory and gustatory dysfunctions due to the coronavirus disease (COVID-19): A review of current evidence","volume":"278","author":"Mehraeen","year":"2021","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1001\/jamainternmed.2020.2033","article-title":"Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients with COVID-19","volume":"180","author":"Liang","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1001\/jamainternmed.2020.2020","article-title":"Contact Tracing Assessment of COVID-19 Transmission Dynamics in Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset","volume":"180","author":"Cheng","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"102474","DOI":"10.1016\/j.amjoto.2020.102474","article-title":"Upper airway symptoms in coronavirus disease 2019 (COVID-19)","volume":"41","author":"Lovato","year":"2020","journal-title":"Am. J. Otolaryngol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1685.e7","DOI":"10.1016\/j.cmi.2020.08.017","article-title":"Epidemiological and clinical characteristics of SARS-CoV-2 infections at a testing site in Berlin, Germany, March and April 2020\u2014A cross-sectional study","volume":"26","author":"Maechler","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Seligmann, H., Iggui, S., Rachdi, M., Vuillerme, N., and Demongeot, J. (2020). Inverted Covariate Effects for First versus Mutated Second Wave Covid-19: High Temperature Spread Biased for Young. Biology, 9.","DOI":"10.3390\/biology9080226"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3389\/fpubh.2019.00043","article-title":"Development of the Intimate Partner Violence During Pregnancy Instrument (IPVPI)","volume":"7","author":"Doi","year":"2019","journal-title":"Front. Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1007\/s00134-003-1761-8","article-title":"A readers\u2019 guide to the interpretation of diagnostic test properties: Clinical example of sepsis","volume":"29","author":"Fischer","year":"2003","journal-title":"Intensive Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1126\/science.3287615","article-title":"Measuring the accuracy of diagnostic systems","volume":"240","author":"Swets","year":"1988","journal-title":"Science"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1002\/jmv.25748","article-title":"Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures","volume":"92","author":"Wang","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6797","DOI":"10.1007\/s00330-020-07022-1","article-title":"A predictive model and scoring system combining clinical and CT characteristics for the diagnosis of COVID-19","volume":"30","author":"Qin","year":"2020","journal-title":"Eur. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.bjid.2020.06.009","article-title":"A predictive score for COVID-19 diagnosis using clinical, laboratory and chest image data","volume":"24","author":"Vieceli","year":"2020","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1007\/s00134-020-05991-x","article-title":"Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China","volume":"46","author":"Ruan","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Luo, L., Luo, Z., Jia, Y., Zhou, C., He, J., Lyu, J., and Shen, X. (2020). CT differential diagnosis of COVID-19 and non-COVID-19 in symptomatic suspects: A practical scoring method. BMC Pulm. Med., 20.","DOI":"10.1186\/s12890-020-1170-6"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Vuichard-Gysin, D., Mertz, D., Pullenayegum, E., Singh, P., Smieja, M., and Loeb, M. (2019). Development and validation of clinical prediction models to distinguish influenza from other viruses causing acute respiratory infections in children and adults. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0212050"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.3201\/eid2610.202573","article-title":"Coronavirus Disease Exposure and Spread from Nightclubs, South Korea","volume":"26","author":"Kang","year":"2020","journal-title":"Emerg. Infect. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/4\/854\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:26:14Z","timestamp":1760160374000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/4\/854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,19]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["jcm10040854"],"URL":"https:\/\/doi.org\/10.3390\/jcm10040854","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2021,2,19]]}}}