학술논문
Admission COVID-19 clinical risk assessment for guiding patient placement and diagnostic testing strategy.
Document Type
Article
Author
Source
Subject
*AUDITING
*COVID-19
*MEDICAL triage
*PREVENTION of communicable diseases
*RETROSPECTIVE studies
*PATIENTS
*RISK assessment
*HOSPITAL admission & discharge
*PREDICTIVE validity
*DIAGNOSTIC errors
*COVID-19 testing
*MEDICAL logic
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Language
ISSN
1470-2118
Abstract
Introduction Without universal access to point-of-care SARS-CoV-2 testing, many hospitals rely on clinical judgement alone for identifying cases of COVID-19 early. Methods Cambridge University Hospitals NHS Foundation Trust introduced a 'traffic light' clinical judgement aid to the COVID-19 admissions unit in mid-March 2020. Ability to accurately predict COVID-19 was audited retrospectively across different stages of the epidemic. Results One SARS-CoV-2 PCR positive patient (1/41, 2%) was misallocated to a 'green' (non-COVID-19) area during the first period of observation, and no patients (0/32, 0%) were mislabelled 'green' during the second period. 33 of 62 (53%) labelled 'red' (high risk) tested SARS-CoV-2 PCR positive during the first period, while 5 of 22 (23%) 'red' patients were PCR positive in the second. Conclusion COVID-19 clinical risk stratification on initial assessment effectively identifies non-COVID-19 patients. However, diagnosing COVID-19 is challenging and risk of overcalling COVID-19 should be recognised, especially when background prevalence is low. [ABSTRACT FROM AUTHOR]