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[Risk stratification through implementation and evaluation of a COVID-19 score : A retrospective diagnostic study].

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A new COVID-19 score helps identify at-risk patients in emergency departments. This symptom-based tool aids in early isolation and treatment decisions for coronavirus disease 2019 (COVID-19).

Keywords:
COVID-19Emergency departmentEmergency medicineSARS-CoV‑2Score

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Area of Science:

  • Emergency Medicine
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Clinical presentation of COVID-19 is often nonspecific, complicating differentiation from other viral infections.
  • Diagnosing COVID-19 with high certainty based on individual or combined findings is challenging.
  • Early identification of at-risk patients in emergency departments is crucial for pre-emptive isolation.

Purpose of the Study:

  • To develop and validate a symptom-based score for early risk assessment of COVID-19 in emergency departments.
  • To enable pre-emptive isolation and management of patients with suspected COVID-19.
  • To improve the diagnostic pathway for coronavirus disease 2019.

Main Methods:

  • A multicentric retrospective evaluation was conducted in three German emergency departments.
  • Data from 697 patients with suspected COVID-19 were analyzed between March 9 and April 30, 2020.
  • A symptom-based COVID-19 score was developed and validated against SARS-CoV-2 PCR testing.

Main Results:

  • The study included 697 patients, with a 9.4% COVID-19 diagnosis rate.
  • A COVID-19 score of ≥5 points significantly increased the likelihood of illness.
  • The score demonstrated high sensitivity (98.4%) but moderate specificity (48.3%).

Conclusions:

  • The developed COVID-19 score facilitates early risk stratification in emergency settings.
  • It supports pre-emptive isolation, PCR testing, and treatment decisions.
  • High sensitivity is achieved at the cost of moderate specificity due to nonspecific symptoms.