@article{13740,
  author = {Jamie J. Coleman and Kaveh Manavi and Ella J Marson and Adam H Botkai and Elizabeth Sapey},
  title = {COVID-19: to be or not to be; that is the diagnostic question},
  abstract = {<jats:p>Since the first cases in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread across the globe, resulting in the COVID-19 pandemic. Early clinical experiences have demonstrated the wide spectrum of SARS-CoV-2 presentations, including various reports of atypical presentations of COVID-19 and possible mimic conditions.</jats:p><jats:p>This article summarises the current evidence surrounding atypical presentations of COVID-19 including neurological, cardiovascular, gastrointestinal, otorhinolaryngology and geriatric features. A case from our hospital of pneumocystis pneumonia initially suspected to be COVID-19 forms the basis for a discussion surrounding mimic conditions of COVID-19. The dual-process model of clinical reasoning is used to analyse the thought processes used to make a diagnosis of COVID-19, including consideration of the variety of differential diagnoses.</jats:p><jats:p>While SARS-CoV-2 is likely to remain on the differential diagnostic list for a plethora of presentations for the foreseeable future, clinicians should be cautious of ignoring other potential diagnoses due to availability bias. An awareness of atypical presentations allows SARS-CoV-2 to be a differential so that it can be appropriately investigated. A knowledge of infectious mimics prevents COVID-19 from overshadowing other diagnoses, hence preventing delayed diagnosis or even misdiagnosis and consequent adverse outcomes for patients.</jats:p>},
  year = {2020},
  journal = {Postgrad Med J},
  volume = {96},
  chapter = {392-398},
  pages = {392-398},
  month = {06/2020},
  issn = {0032-5473},
  doi = {10.1136/postgradmedj-2020-137979},
}