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A new rapid screening program based on risk scores for COVID-19 patients
Ru Chen1, Guilan Xu2, Lihui Yang3
1Neurological Department, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
Insights
A new COVID-19 risk score effectively screens patients to reduce hospital transmission. This rapid assessment tool identifies high-risk individuals, aiding in efficient COVID-19 prevention and management strategies.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Hospital-related transmission is a significant factor in the spread of COVID-19.
- Effective and rapid screening strategies are crucial for COVID-19 prevention.
- Existing screening methods may lack sufficient accuracy and efficiency.
Purpose of the Study:
- To establish a novel COVID-19 risk score system for rapid patient screening.
- To reduce the risk of hospital-related COVID-19 transmission.
- To compare the effectiveness of the new risk score against existing screening schemes.
Main Methods:
- Analysis of 335 patients, including 124 with COVID-19.
- Selection of five significant clinical attributes (exposure, cluster onset, fever, cough, atypical symptoms) to construct the risk score.
- Comparison of screening effectiveness using receiver operating characteristic (ROC) curves for three schemes.
Main Results:
- A new COVID-19 risk score was developed using five key factors.
- The score effectively categorizes patients into low, medium, and high-risk subgroups.
- The COVID-19 risk score system demonstrated superior screening effectiveness (AUC=0.96) compared to temperature screening (AUC=0.56) and exposure/fever screening (AUC=0.85).
Conclusions:
- The developed COVID-19 risk score system enables rapid and effective identification of COVID-19 patients.
- This tool can significantly aid clinicians in managing COVID-19, particularly in areas with ongoing transmission.
- The new system offers improved sensitivity (93.6%) and specificity (86.3%) at a cut-off score of 10.
Abstract:
We aimed at establishing a new COVID-19 risk scores, serving as a guide for rapidly screening the COVID-19 patients in order to reduce the risk of COVID-19 hospital-related transmission. As the COVID-19 disease is breaking out across the world, hospital-related transmission is one of the main factors accountable for the spread of COVID-19. For COVID-19 prevention it is urgent to establish a fast and efficient screening strategy for the COVID-19 patients. We analyzed 335 patients (including 124 patients with COVID-19). Five significant clinical attributes were selected as the components for establishing a COVID-19 risk score system, and every attribute was assigned a specific score according to their respective odds ratio values. We also compared three different screening schemes (Scheme I: temperature higher than 37.2 °C on admission, Scheme II: exposure to a source of transmission within 14 days in addition to fever, Scheme III: our new COVID-19 risk score) in terms of their respective receiver operating characteristic (ROC) curves, so as to evaluate their respective screening effectiveness. Five significant risk factors, which were exposed to a source of transmission (9 points), cluster onset (6 points), history of fever or temperature higher than 37.2 °C on admission (4 points), cough (1 point) and other atypical symptoms (1 point), were ultimately selected from many candidates to construct the new rapid COVID-19 screening program. Based on the screening scheme, the patients were quickly divided into three subgroups according to their respective COVID-19 risk scores: low risk (≤ 6 points, risk < 10%), medium risk (7-13 points) and high risk (≥ 14 points, risk > 80%). When the score of 10 points was selected as a cut-off point for differentiating the patients with COVID-19 from all of the other patients, the sensitivity was 93.6%, with a specificity of 86.3%. The area under the ROC curve (AUC) of COVID-19 risk score system was 0.96 (P = 0.000), much higher than the AUCs of Scheme I (0.56, P = 0.000) and Scheme II (0.85, P = 0.000), respectively. Our COVID-19 risk score system can help the clinicians effectively and rapidly identify and differentiate the patients with COVID-19 infections, to be mainly used in those areas where COVID-19 still exhibits epidemiological characteristics.
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