• Gary M Vilke, Jesse J Brennan, Alexandrea O Cronin, and Edward M Castillo.
• Department of Emergency Medicine, University of California San Diego, San Diego, California.
• J Emerg Med. 2020 Dec 1; 59 (6): 952-956.

BackgroundAs many businesses reopen after government-induced restrictions, many public agencies and private companies, such as banks, golf courses, and stores, are using temperature screening to assess for possible coronavirus disease 2019 (COVID-19) infection both for patrons and for employees.ObjectiveWe assessed the frequency of a fever ≥100.4°F and other symptoms associated with COVID-19 among patients in the emergency department (ED) who were tested in the ED for the illness.MethodsThis is a retrospective review of data from patients who were tested for acute COVID-19 infection from March 10, 2020 through June 30, 2020 at two EDs within the same health care system. Data collected included temperature, the presence or recent history of COVID-19-related symptoms, and COVID-19 test results. Descriptive statistics are reported for presenting fever and other COVID-19-related symptoms alone and in combination with presenting fever.ResultsA total of 6894 patients were tested for COVID-19. Among these, 330 (4.8%) tested positive for active infection. Of these patients, 64 (19.4%) presented with a fever ≥100.4°F (≥38.0°C). Increasing the number of COVID-19-related symptoms in combination with a presenting fever ≥100.4°F increased the number of people who could be identified as having a COVID-19 infection.ConclusionsAbout a quarter of patients who were tested positive for COVID-19 in our ED did not have a fever at presentation ≥100.4°F. Using only temperature to screen for COVID-19 in the community setting will likely miss the majority of patients with active disease.Copyright © 2020 Elsevier Inc. All rights reserved.

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