Real-World Evidence: The Low Validity of Temperature Screening for COVID-19 Triage
Open Access
- 30 June 2021
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Public Health
- Vol. 9, 672698
- https://doi.org/10.3389/fpubh.2021.672698
Abstract
Background: The COVID-19 pandemic forced health-related organizations to rapidly launch country-wide procedures that were easy to use and inexpensive. Body temperature measurement with non-contact infrared thermometers (NCITs) is among the most common procedures, both in hospital settings and in many other entities. However, practical hospital experiences have raised great doubts about the procedure's validity. Aim: This study aimed to evaluate the validity of the body temperature measured using NCITs among oncological and transplant patients who took the polymerase chain reaction test for SARS-Cov-2 PCR+ and PCR- in a Romanian Hospital. Methods: Body temperature was measured for 5,231 inpatients using NCITs. The cutoff point for fever was equal to or above 37.3°C. Patients then completed a questionnaire about their symptoms, contact, and travel history. Findings: Fever was detected in five of 53 persons with PCR+, resulting in a sensitivity of 9.43% (95% CI, 3.13–20.66%). No fever was verified in 5,131 of 5,171 persons with PCR-, resulting in a specificity of 99.15% (95% CI, 98.86–99.38%). A defensive vision of NCIT procedure (maximum standard error only in favor) had a sensitivity of 15.09% (95% CI, 6.75–27.59%). Conclusions: The use of NCITs in a triage provides little value for detection of COVID-19. Moreover, it provides a false sense of protection against the disease while possibly discriminating individuals that could present fever due to other reasons, such as oncologic treatments, where fever is a common therapeutical consequence. The consumption of qualified human resources should be considered, especially in the context of the shortage of healthcare professionals worldwide.This publication has 17 references indexed in Scilit:
- Under the coronavirus disease 2019 (COVID-19) pandemic circumstance, how to administrate cancer patients with fever during radiotherapyRadiotherapy and Oncology, 2020
- Measurement of body temperature to prevent pandemic COVID-19 in hospitals in Taiwan: repeated measurement is necessaryJournal of Hospital Infection, 2020
- Clinical progression of patients with COVID-19 in Shanghai, ChinaJournal of Infection, 2020
- Coronavirus disease-2019: is fever an adequate screening for the returning travelers?Tropical Medicine and Health, 2020
- Effectiveness of airport screening at detecting travellers infected with novel coronavirus (2019-nCoV)Eurosurveillance, 2020
- Respiratory Virus Infections in Hematopoietic Cell Transplant RecipientsFrontiers in Microbiology, 2019
- Fever of unknown originClinical Medicine, 2015
- Management of Respiratory Viral Infections in Hematopoietic Cell Transplant Recipients and Patients With Hematologic MalignanciesClinical Infectious Diseases, 2014
- Fever of unknown origin: Discrimination between infectious and non-infectious causesEuropean Journal of Internal Medicine, 2010