Suspected COVID-19 case definition: a narrative review of the most frequent signs and symptoms among confirmed cases

Abstract

Objective: to describe the most frequent signs and symptoms of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: this is a narrative literature review carried out in April 2020; the search was performed on electronic databases and complemented with a manual review of the references of the selected papers and Brazilian Ministry of Health publications. Results: the spectrum of clinical disease was wide; fever, coughing and dyspnea were the most frequent signs/symptoms, however, they may not be present, thus hindering case definition. gastrointestinal symptoms and loss of taste or smell have been reported among mild cases; dyspnea was frequent among severe and fatal cases. Conclusion: considering the scarcity of diagnostic tests and the diversity of symptoms, health services should use a sensitive case definition, in order to adopt appropriate surveillance, prevention and treatment actions.