Tutorial presented by Dr Simon Barry, National Respiratory Clinical Lead, and Karen Vennard, Respiratory Nurse Specialist.
A number of respiratory conditions may present in a similar way to COVID-19 infection. Identifying the underlying cause of the problem is paramount to deciding the correct management. If COVID-19 is suspected, ensure the patient gets tested immediately.
The differential diagnosis of patients presenting with suspected COVID-19 include:
Patients will often present with productive cough, fever, breathlessness, tachycardia, tachypnoea, and hypotension. This makes it very difficult to distinguish between pneumonia and COVID-19 and a physical examination may be necessary.
Exacerbation, or worsening of an underlying lung disease such as COPD, Asthma or Interstitial Lung Disease (ILD)
Patients commonly present with symptoms of increased breathlessness, cough and a fever; however a productive cough with copious amounts of purulent sputum will likely indicate a bacterial infection. Always ask the patient if these are typical features of an exacerbation. An asthma exacerbation typically presents with chest tightness and wheezing which is not a common feature of COVID-19.
Other viral illnesses
Patients commonly present with fever, dry cough, and myalgia; however a runny nose is often present, which is not a common feature of COVID-19.
It’s also important to consider patients who might be immunocompromised and have a higher chance of acquiring opportunistic infections that can mimic the presentation of COVID-19.