tetano
Editor, Senior Moderator
J Clin Med
. 2020 Oct 7;9(10):E3217.
doi: 10.3390/jcm9103217.
COVID-19 Triage and Test Center: Safety, Feasibility, and Outcomes of Low-Threshold Testing
Gregory Mansella[SUP] 1 [/SUP], Marco Rueegg[SUP] 1 [/SUP], Andreas F Widmer[SUP] 2 [/SUP], Sarah Tschudin-Sutter[SUP] 2 [/SUP], Manuel Battegay[SUP] 2 [/SUP], Julia Hoff[SUP] 1 [/SUP], Kirstine K S?gaard[SUP] 3 4 [/SUP], Adrian Egli[SUP] 3 4 [/SUP], Bram Stieltjes[SUP] 5 [/SUP], Karoline Leuzinger[SUP] 6 7 [/SUP], Hans H Hirsch[SUP] 2 6 7 [/SUP], Andrea Meienberg[SUP] 8 [/SUP], Thilo Burkard[SUP] 8 [/SUP], Michael Mayr[SUP] 8 [/SUP], Roland Bingisser[SUP] 1 [/SUP], Christian H Nickel[SUP] 1 [/SUP]
Affiliations
Abstract
This prospective observational study evaluated the safety and feasibility of a low threshold testing process in a Triage and Test Center (TTC) during the early course of the coronavirus disease 19 (COVID-19) pandemic. In addition, we aimed to identify clinical predictors for a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swab result. Patients underwent informal triage, standardized history taking, and physician evaluation, only where indicated. Patients were observed for 30 days. Safety was the primary outcome and was defined as a COVID-19-related 30 day re-presentation rate <5% and mortality rate <1% in patients presenting to the TTC. Feasibility was defined as an overruling of informal triage <5%. Among 4815 presentations, 572 (11.9%) were tested positive for SARS-CoV-2, and 4774 were discharged. Mortality at 30-days was 0.04% (2 patients, one of which related to COVID-19). Fever (OR 2.03 [95% CI 1.70;2.42]), myalgia (OR 1.94 [1.63;2.31]), chills (OR 1.77 [1.44;2.16]), headache (OR 1.61 [1.34;1.94]), cough (OR 1.50 [1.24;1.83]), weakness (OR 1.46 [1.21;1.76]), and confusion (OR 1.39 [1.06;1.80]) were associated with test positivity. Re-presentation rate was 8% overall and 1.4% in COVID-19 related re-presentation (69 of 4774). The overruling rate of informal triage was 1.5%. According to our study, a low-threshold testing process in a TTC appeared to be safe (low re-presentation and low mortality) and is feasible (low overruling of informal triage). A COVID-19 diagnosis based on clinical parameters only does not appear possible.
Keywords: COVID-19; SARS-CoV-2; Triage and Test Center; disposition; drive-thru testing; resource allocation; symptoms.
. 2020 Oct 7;9(10):E3217.
doi: 10.3390/jcm9103217.
COVID-19 Triage and Test Center: Safety, Feasibility, and Outcomes of Low-Threshold Testing
Gregory Mansella[SUP] 1 [/SUP], Marco Rueegg[SUP] 1 [/SUP], Andreas F Widmer[SUP] 2 [/SUP], Sarah Tschudin-Sutter[SUP] 2 [/SUP], Manuel Battegay[SUP] 2 [/SUP], Julia Hoff[SUP] 1 [/SUP], Kirstine K S?gaard[SUP] 3 4 [/SUP], Adrian Egli[SUP] 3 4 [/SUP], Bram Stieltjes[SUP] 5 [/SUP], Karoline Leuzinger[SUP] 6 7 [/SUP], Hans H Hirsch[SUP] 2 6 7 [/SUP], Andrea Meienberg[SUP] 8 [/SUP], Thilo Burkard[SUP] 8 [/SUP], Michael Mayr[SUP] 8 [/SUP], Roland Bingisser[SUP] 1 [/SUP], Christian H Nickel[SUP] 1 [/SUP]
Affiliations
- PMID: 33036445
- DOI: 10.3390/jcm9103217
Abstract
This prospective observational study evaluated the safety and feasibility of a low threshold testing process in a Triage and Test Center (TTC) during the early course of the coronavirus disease 19 (COVID-19) pandemic. In addition, we aimed to identify clinical predictors for a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swab result. Patients underwent informal triage, standardized history taking, and physician evaluation, only where indicated. Patients were observed for 30 days. Safety was the primary outcome and was defined as a COVID-19-related 30 day re-presentation rate <5% and mortality rate <1% in patients presenting to the TTC. Feasibility was defined as an overruling of informal triage <5%. Among 4815 presentations, 572 (11.9%) were tested positive for SARS-CoV-2, and 4774 were discharged. Mortality at 30-days was 0.04% (2 patients, one of which related to COVID-19). Fever (OR 2.03 [95% CI 1.70;2.42]), myalgia (OR 1.94 [1.63;2.31]), chills (OR 1.77 [1.44;2.16]), headache (OR 1.61 [1.34;1.94]), cough (OR 1.50 [1.24;1.83]), weakness (OR 1.46 [1.21;1.76]), and confusion (OR 1.39 [1.06;1.80]) were associated with test positivity. Re-presentation rate was 8% overall and 1.4% in COVID-19 related re-presentation (69 of 4774). The overruling rate of informal triage was 1.5%. According to our study, a low-threshold testing process in a TTC appeared to be safe (low re-presentation and low mortality) and is feasible (low overruling of informal triage). A COVID-19 diagnosis based on clinical parameters only does not appear possible.
Keywords: COVID-19; SARS-CoV-2; Triage and Test Center; disposition; drive-thru testing; resource allocation; symptoms.