Admission COVID-19 clinical risk assessment for guiding patient placement and diagnostic testing strategy
Open Access
- 1 March 2021
- journal article
- research article
- Published by Elsevier BV in Clinical Medicine
- Vol. 21 (2), e140-e143
- https://doi.org/10.7861/clinmed.2020-0519
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.This publication has 17 references indexed in Scilit:
- Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CTRadiology, 2020
- Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 CasesRadiology, 2020
- Sensitivity of Chest CT for COVID-19: Comparison to RT-PCRRadiology, 2020
- Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of InfectionRadiology, 2020
- Clinical Characteristics of Coronavirus Disease 2019 in ChinaThe New England Journal of Medicine, 2020
- SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected PatientsThe New England Journal of Medicine, 2020
- Detection of SARS-CoV-2 in Different Types of Clinical SpecimensJAMA, 2020
- Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive studyThe Lancet Infectious Diseases, 2020
- Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational studyThe Lancet Respiratory Medicine, 2020
- Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei ProvinceChinese Medical Journal, 2020